Abstract
This study compared the 1-item Strength of Urges to Drink (SUTD) scale with the 10-item Alcohol Use Disorders Identification Test (AUDIT) on (i) test-retest reliability, (ii) predictive validity, and (iii) diagnostic accuracy. Data come from 2960 participants taking part in the Alcohol Toolkit Study (ATS), a monthly population survey of adults in England. The long-term test-retest reliability of the SUTD was ‘fair’, but lower than that for the AUDIT (Kappaweighted 0.24 versus 0.49). Individuals with “slight/moderate” urges to drink had higher odds of reporting an attempt to cut down relative to those not experiencing urges (adjusted odds ratios (AdjORs) 1.78 95% confidence interval (CI) 1.43–2.22 and 1.54 95% CI 1.20–1.96). Drinkers reporting “moderate/slight/strong” urges to drink had mean change in consumption scores which were 0.16 (95% CI −0.31 to −0.02), 0.40 (95% CI −0.56 to −0.24) and 0.37 (95% CI −0.69 to −0.05) units lower than those reporting no urges. For all outcomes, strong associations were found with AUDIT scores. The accuracy of the SUTD for discriminating between drinkers who did and did not reduce their consumption was ‘acceptable’, and similar to that for the AUDIT (ROCAUC 0.6). The AUDIT had better diagnostic accuracy in predicting change in alcohol consumption. The SUTD may be an efficient dynamic measure of urges to drink for population surveys and studies assessing the impact of alcohol-reduction interventions.
Highlights
Worldwide each year around 6 L on average of pure alcohol are consumed by every person aged 15 years or older [1]
In unadjusted analyses, a positive association was found between Alcohol Use Disorders Identification Test (AUDIT) scores and consumption levels (β 0.13, 95% CI 0.11 to 0.14, p < 0.001)
When restricting the analysis to those cutting down at baseline, the ROCAUC’s were as follows: Strength of Urges to Drink (SUTD) (0.5; 95% CI 0.5 to 0.6), SUTD-3 (0.5; 95% CI 0.4 to 0.6) and AUDIT (0.7; 95% CI 0.6 to 0.7)
Summary
Worldwide each year around 6 L on average of pure alcohol are consumed by every person aged 15 years or older [1]. In England, around 17% (~9 million) of adults drink alcohol above recommended limits [2] and 6% (~1 million) of the population are classified as dependent i.e., they have a physical and/or mental dependency on alcohol which is associated with high levels of tolerance to its effects and withdrawal symptoms when absent [3]. Such consumption levels are associated with a number of non-communicable diseases, injury and alcohol attributable death each year [1]. Public Health 2019, 16, 3714; doi:10.3390/ijerph16193714 www.mdpi.com/journal/ijerph
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