Screening trauma patients with the alcohol use disorders identification test and biomarkers of alcohol use

Tim Neumann, Larry M. Gentilello, Bruno Neuner, Edith Weiß-Gerlach, Hajo Schürmann, Torsten Schröder, Christian Müller, Norbert P. Haas, Claudia D. Spies

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Alcohol screening and brief interventions have been shown to reduce alcohol-related morbidity in injured patients. Use of self-report questionnaires such as the Alcohol Use Disorder Identification Test (AUDIT) is recommended as the optimum screening method. We hypothesized that the accuracy of screening is enhanced by combined use of the AUDIT and biomarkers of alcohol use in injured patients. Methods: The study was conducted in the emergency department of a large, urban, university hospital. Patients were evaluated with the AUDIT, and blood sampled to determine carbohydrate-deficient transferrin, gamma-glutamyl-transferase, and mean corpuscular volume. Alcohol problems were defined as presence of ICD-10 criteria for dependence or harmful use, or high-risk drinking according to World Health Organization criteria (weekly intake >420 g in males, >280 g in females). Screening accuracy was determined using Receiver Operating Characteristic curves. Results: There were 787 males and 446 females in the study. Median age was 33 years. The accuracy of the AUDIT was good to excellent, whereas all biomarkers performed only fairly to poorly in males, and even worse in females. At a specificity >0.80, sensitivity for all biomarkers was <0.43, whereas sensitivity for the AUDIT was 0.76 for males and 0.81 for females. The addition of biomarkers added little additional discriminatory information compared to use of the AUDIT alone. Conclusions: Screening properties of the AUDIT are superior to %CDT, MCV, and GGT for detection of alcohol problems in injured patients and are not clinically significantly enhanced by the use of biomarkers.

Original languageEnglish (US)
Pages (from-to)970-976
Number of pages7
JournalAlcoholism: Clinical and Experimental Research
Volume33
Issue number6
DOIs
StatePublished - Jun 2009

Fingerprint

Biomarkers
Screening
Alcohols
Wounds and Injuries
Erythrocyte Indices
Urban Hospitals
Hematologic Tests
International Classification of Diseases
Transferases
ROC Curve
Self Report
Drinking
Hospital Emergency Service
Blood
Health
Morbidity

Keywords

  • Alcohol
  • Alcohol use disorder identification Test
  • Carbohydrate-Deficient Transferrin
  • Gamma-Glutamyl-Transferase
  • Injury
  • Mean Corpuscular Volume
  • Sensitivity and Specificity
  • Trauma

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Toxicology

Cite this

Neumann, T., Gentilello, L. M., Neuner, B., Weiß-Gerlach, E., Schürmann, H., Schröder, T., ... Spies, C. D. (2009). Screening trauma patients with the alcohol use disorders identification test and biomarkers of alcohol use. Alcoholism: Clinical and Experimental Research, 33(6), 970-976. https://doi.org/10.1111/j.1530-0277.2009.00917.x

Screening trauma patients with the alcohol use disorders identification test and biomarkers of alcohol use. / Neumann, Tim; Gentilello, Larry M.; Neuner, Bruno; Weiß-Gerlach, Edith; Schürmann, Hajo; Schröder, Torsten; Müller, Christian; Haas, Norbert P.; Spies, Claudia D.

In: Alcoholism: Clinical and Experimental Research, Vol. 33, No. 6, 06.2009, p. 970-976.

Research output: Contribution to journalArticle

Neumann, T, Gentilello, LM, Neuner, B, Weiß-Gerlach, E, Schürmann, H, Schröder, T, Müller, C, Haas, NP & Spies, CD 2009, 'Screening trauma patients with the alcohol use disorders identification test and biomarkers of alcohol use', Alcoholism: Clinical and Experimental Research, vol. 33, no. 6, pp. 970-976. https://doi.org/10.1111/j.1530-0277.2009.00917.x
Neumann, Tim ; Gentilello, Larry M. ; Neuner, Bruno ; Weiß-Gerlach, Edith ; Schürmann, Hajo ; Schröder, Torsten ; Müller, Christian ; Haas, Norbert P. ; Spies, Claudia D. / Screening trauma patients with the alcohol use disorders identification test and biomarkers of alcohol use. In: Alcoholism: Clinical and Experimental Research. 2009 ; Vol. 33, No. 6. pp. 970-976.
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abstract = "Background: Alcohol screening and brief interventions have been shown to reduce alcohol-related morbidity in injured patients. Use of self-report questionnaires such as the Alcohol Use Disorder Identification Test (AUDIT) is recommended as the optimum screening method. We hypothesized that the accuracy of screening is enhanced by combined use of the AUDIT and biomarkers of alcohol use in injured patients. Methods: The study was conducted in the emergency department of a large, urban, university hospital. Patients were evaluated with the AUDIT, and blood sampled to determine carbohydrate-deficient transferrin, gamma-glutamyl-transferase, and mean corpuscular volume. Alcohol problems were defined as presence of ICD-10 criteria for dependence or harmful use, or high-risk drinking according to World Health Organization criteria (weekly intake >420 g in males, >280 g in females). Screening accuracy was determined using Receiver Operating Characteristic curves. Results: There were 787 males and 446 females in the study. Median age was 33 years. The accuracy of the AUDIT was good to excellent, whereas all biomarkers performed only fairly to poorly in males, and even worse in females. At a specificity >0.80, sensitivity for all biomarkers was <0.43, whereas sensitivity for the AUDIT was 0.76 for males and 0.81 for females. The addition of biomarkers added little additional discriminatory information compared to use of the AUDIT alone. Conclusions: Screening properties of the AUDIT are superior to {\%}CDT, MCV, and GGT for detection of alcohol problems in injured patients and are not clinically significantly enhanced by the use of biomarkers.",
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AU - Schröder, Torsten

AU - Müller, Christian

AU - Haas, Norbert P.

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N2 - Background: Alcohol screening and brief interventions have been shown to reduce alcohol-related morbidity in injured patients. Use of self-report questionnaires such as the Alcohol Use Disorder Identification Test (AUDIT) is recommended as the optimum screening method. We hypothesized that the accuracy of screening is enhanced by combined use of the AUDIT and biomarkers of alcohol use in injured patients. Methods: The study was conducted in the emergency department of a large, urban, university hospital. Patients were evaluated with the AUDIT, and blood sampled to determine carbohydrate-deficient transferrin, gamma-glutamyl-transferase, and mean corpuscular volume. Alcohol problems were defined as presence of ICD-10 criteria for dependence or harmful use, or high-risk drinking according to World Health Organization criteria (weekly intake >420 g in males, >280 g in females). Screening accuracy was determined using Receiver Operating Characteristic curves. Results: There were 787 males and 446 females in the study. Median age was 33 years. The accuracy of the AUDIT was good to excellent, whereas all biomarkers performed only fairly to poorly in males, and even worse in females. At a specificity >0.80, sensitivity for all biomarkers was <0.43, whereas sensitivity for the AUDIT was 0.76 for males and 0.81 for females. The addition of biomarkers added little additional discriminatory information compared to use of the AUDIT alone. Conclusions: Screening properties of the AUDIT are superior to %CDT, MCV, and GGT for detection of alcohol problems in injured patients and are not clinically significantly enhanced by the use of biomarkers.

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