Danish validation of the Alcohol Use Disorder Identification Test (AUDIT)

To assess the diagnostic accuracy and optimal cut-off scores of the Alcohol Use Disorder Identification Test (AUDIT) and AUDIT-Consumption (AUDIT-C) in a Danish general population.

Questionnaire-based cross-sectional study. Data collection from 26 September to 29 October 2024, via an anonymous online test of alcohol habits among adults aged 25+ years.

Demographics, AUDIT, self-reported International Classification of Disease Tenth Revision (ICD-10) criteria for alcohol dependence, yes/no item on harmful alcohol use. We defined hazardous use as >10 standard drinks/week (national recommendations) and possible dependence as ⩾3 ICD-10 criteria. We evaluated area under the receiver operating characteristics curve (AUC), diagnostic properties and optimal cut-offs.

Total sample: 17,959 participants, mean age 66.32 (SD=12.72) years, 51% males. Nineteen per cent reported drinking hazardously, 7.5% answered yes to harmful use and 7.8% to dependence according to ICD-10. AUDIT showed good diagnostic discrimination for hazardous use (AUC=0.89) and dependence (AUC=0.96), but not for harmful use (AUC=0.61). Internationally recommended AUDIT cut-offs for hazardous use and dependence were supported, with lower thresholds in women and the older (65+ years). AUDIT-C: hazardous use (AUC=0.92), dependence (AUC=0.92), harmful use (AUC=0.58). Optimal AUDIT-C cut-offs: hazardous 6, dependence 6, with age- and sex-specific variations. Internal consistency was high for AUDIT (α = 0.83) and low for AUDIT-C (α = 0.61).

Both instruments performed well for detecting hazardous use and possible dependence but not for harmful use. AUDIT-C might serve as an initial screening tool for hazardous drinking, followed by the full AUDIT for detailed assessment. Local circumstances should be considered when defining appropriate cut-offs for AUDIT and AUDIT-C.