Screening instruments to detect problematic alcohol use among adults in hospitals and their diagnostic test accuracy: A systematic review
Drug and Alcohol Review, vol. 44, pp. 505–531
Abstract
ISSUES: Alcohol consumption can cause physical, psychological and social problems that can result in hospitalisations. Screening in hospitals helps to determine which patients should be given interventions. In this review, we aimed to summarise the diagnostic test accuracy (DTA) of screening instruments for problematic alcohol use among adults in hospitals. APPROACH: We searched three databases for studies that assessed validated screening instruments for problematic alcohol use among hospitalised adults. We used the Quality Assessment of Diagnostic Accuracy Studies 2 tool to evaluate the risk of bias. KEY FINDINGS: We included 20 studies in the review. In 11 studies performed in the emergency departments, 5 instruments had a high DTA: the AUDIT, the AUDIT-C, the RAPS4-QF, the 2-question screener and HOLD 5. In the eight studies with inpatients, three instruments had a high DTA: the AUDIT, CAGE-C and CAGE +10 items. Finally, only one of the included studies evaluated outpatients; the authors reported a high DTA for the AUDIT-C. IMPLICATION AND CONCLUSIONS: The results indicate that the AUDIT is an appropriate screening instrument for both inpatients and patients in the emergency department. Moreover, for patients in the emergency department, the AUDIT-C and the RAPS4-QF can be used. More research is needed on outpatients, and several screening instruments have only been validated with one study (i.e., the 2-question screener, DSM-IV-2, HOLD 5, CAGE-C and CAGE +10 questions).
Authors 6
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Jacqueline M. Bisschop corresponding
Tilburg University · Amsterdam University Medical Centers · Jeroen Bosch Ziekenhuis · University of Amsterdam
Affiliation as printed
Department Tranzo Tilburg School of Social and Behavioural Sciences Tilburg the Netherlands
Epidemiology and Data Science Amsterdam University Medical Center, University of Amsterdam Amsterdam the Netherlands
Jeroen Bosch Hospital s‐Hertogenbosch the Netherlands
Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg, the Netherlands
Epidemiology and Data Science, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
Jeroen Bosch Hospital, s-Hertogenbosch, the Netherlands
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Affiliation as printed
Jeroen Bosch Hospital s‐Hertogenbosch the Netherlands
Jeroen Bosch Hospital, s-Hertogenbosch, the Netherlands
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Anja H. Brunsveld‐Reinders Aachen Department Quality and Patient Safety Leiden University Medical Center Leiden the Netherlands Department Quality and Patient Safety
Leiden University Medical Center · Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Department Quality and Patient Safety Leiden University Medical Center Leiden the Netherlands
Epidemiology and Data Science Amsterdam University Medical Center, University of Amsterdam Amsterdam the Netherlands
Department Quality and Patient Safety, Leiden University Medical Center, Leiden, the Netherlands
Epidemiology and Data Science, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Affiliation as printed
Department Tranzo Tilburg School of Social and Behavioural Sciences Tilburg the Netherlands
Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg, the Netherlands
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Affiliation as printed
Department Tranzo Tilburg School of Social and Behavioural Sciences Tilburg the Netherlands
Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg, the Netherlands
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Affiliation as printed
Department Tranzo Tilburg School of Social and Behavioural Sciences Tilburg the Netherlands
Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg, the Netherlands
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