Study Advocates Single-Question Alcohol Screening for Adolescents
A single screening question asking about drinking frequency in the past year could help doctors identify adolescents at risk for alcohol problems, as per a recent study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a part of the National Institutes of Health (NIH). Led by researchers of the University of Pittsburgh, the study strongly supports the use of age-based screening thresholds referred to in the Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide by the NIAAA.
NIAAA director George Koob, Ph.D., said, “Primary care physicians are encouraged to screen adolescents for alcohol problems, yet many do not, citing time constraints and other issues.” But the latest study would immensely help the cause. “This study demonstrates that simple screening tools such as those in NIAAA’s Youth Guide are efficient and effective,” he said.
Alcohol use frequency screen: Cost-effective clinical assessment procedure for alcoholics
Lead researcher Duncan B. Clark, M.D., Ph.D., professor of psychiatry at the University of Pittsburgh Medical Center, and his colleagues interviewed nearly 1,200 young people between 12 and 20 years at primary care clinics in rural Pennsylvania. Using a computer-based questionnaire, the researchers tried to gauge the frequency of their alcohol use and also screened them for alcohol use disorder (AUD).
The results revealed that 10 percent of the rural youth above 14 years met the diagnostic criteria for AUD in the past year, as specified in the Diagnostic and Statistical Manual of Mental Disorders. The adolescents aged between 12 and 17 years drank at least one standard drink on three or more days in the past one year and were at a high risk of developing alcohol problems. Further, 44 percent of them were found to have AUD.
On screening the youth for AUD based on the three-day guideline, the researchers observed 91 percent sensitivity, implying those with AUD were likely to be detected by the screen, and 93 percent specificity, showing those without AUD were likely to have a negative result. On the other side, a negative screen ruled out any chance of developing AUD, with 99 percent not having the disorder.
Single question can be effective tool to screen the youth for AUD
For adolescents aged between 18 and 20, the best screen to track their alcohol problems was to ask whether they had engaged in 12 or more drinking days (i.e., a day in which at least one standard drink is consumed) during the past year. According to the researchers, 31 percent of the respondents had AUD at this level. This demonstrated that a single question can be an effective tool to screen the youth for AUD.
“We found that this information could be readily collected through our tablet computer system in busy rural clinic settings,” said Dr. Clark.
Various studies have shown that alcohol use among rural youth is abnormally high, and so, identifying problem drinking is of particular importance for primary care providers in rural settings. Hence, an alcohol use frequency screen followed by a diagnostic evaluation for those who screen positive should be “a simple, brief, and cost-effective clinical assessment procedure.”
The researchers also assessed screening methods outlined in the NIAAA Youth Screening Guide, which uses age-specific alcohol frequency questions to identify AUD risk ranging from moderate to the highest levels. Both sets of NIAAA guidelines were found to be effective screens for AUD.
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