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Related Experiment Videos

Screening for drinking problems by patient self-report. Even 'safe' levels may indicate a problem

D G Buchsbaum1, J Welsh, R G Buchanan

  • 1Division of General Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond.

Archives of Internal Medicine
|January 9, 1995
PubMed
Summary

Physician screening for serious alcohol problems using patient self-reported drinking quantity is effective. Even moderate alcohol consumption may signal a problem in urban general medicine settings.

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Area of Science:

  • General Medicine
  • Psychiatry
  • Public Health

Background:

  • Physicians commonly screen patients for alcohol use by asking about quantity consumed.
  • The effectiveness of this quantitative screening for serious drinking problems in ambulatory patients has not been previously established.

Purpose of the Study:

  • To evaluate the efficacy of quantitative alcohol consumption self-reports for screening serious drinking problems in general medicine outpatients.
  • To determine the diagnostic accuracy of reported alcohol intake levels.

Main Methods:

  • Interviewed 510 general medicine outpatients using the Diagnostic Interview Schedule (DIS) alcohol module.
  • Collected data on alcohol quantity, frequency, and recency of drinking.
  • Calculated sensitivity, specificity, and receiver operating characteristic (ROC) curves for various drinking quantity thresholds in 155 active drinkers.

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Main Results:

  • Forty-eight of 155 active drinkers met Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria for alcohol abuse or dependence.
  • The area under the ROC curve for reported quantity was 0.81, indicating good discriminative ability.
  • A reported intake of 6-12 drinks per week had a positive predictive value of 0.54 for an active DSM-III-R diagnosis.

Conclusions:

  • Patient self-reported alcohol consumption is a viable method for screening actively drinking outpatients for serious alcohol problems.
  • In urban general medicine settings, even recommended alcohol consumption levels may indicate an underlying issue.
  • Physicians should consider adjusting drinking recommendations based on the patient's practice setting.