Validation of the screening test for at-risk drinking in an emergency department using a tablet computer

Abstract

BackgroundThe Alcohol Use Disorder Identification Test (AUDIT) is widely used and validated in primary care settings for alcohol screening, yet practical challenges in conducting it in crowded clinics exist. Recently, a new abbreviated version of the AUDIT, was presented: the Screening Test for At-risk Drinking (STAD). This study aimed to evaluate the performance of STAD compared to other abbreviated versions of AUDIT for patients visiting the emergency department (ED). MethodsThis cross-sectional survey was conducted with 543 patients in the urban tertiary academic hospital ED in South Korea We diagnosed at-risk drinking using the entire AUDIT score. The optimal cut-off values, sensitivity, specificity, and the area under the receiver operating characteristics (AUROC) of the STAD were analyzed. We compared the AUROC with AUDIT-C and AUDIT-QF, which are previously abbreviated versions of AUDIT. ResultsFor males, the optimal cut-off value in the STAD test was 3 points with 83.1% sensitivity (95% CI: 75.3–89.2) and 95.9% specificity (95% CI: 91.2–98.5). For females, the optimal cut-off value was 2 points with 95.9% sensitivity (95% CI: 88.5–99.1) and 89.1% specificity (95% CI: 83.9–93.0). The AUROC curves for STAD were 0.964 (95% CI: 0.934–0.983) for males and 0.980 (95% CI: 0.965–0.993) for females. ConclusionsThe STAD is a simple and useful test to screen at-risk drinking in the ED, and its assisted applications will enable faster and more efficient screening and management of at-risk drinking.