The Alcohol Use Disorders Identification Test (AUDIT) as a Screening Tool for Excessive Drinking in Primary Care: Reliability and Validity of a French Version

Authors

  • Pascal Gache,

    Corresponding author
    1. Alcohology Unit Department of Community Medicine (PG, CA, OW), Hôpitaux Universitaires de Genève, Switzerland, Programme ‘Boire moins c'est mieux’ (SA, PM), National Association for Prevention of Alcoholism, (Paris), France, Centre for Treatment in Alcohology; (UL, JBD), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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  • Philippe Michaud,

    1. Alcohology Unit Department of Community Medicine (PG, CA, OW), Hôpitaux Universitaires de Genève, Switzerland, Programme ‘Boire moins c'est mieux’ (SA, PM), National Association for Prevention of Alcoholism, (Paris), France, Centre for Treatment in Alcohology; (UL, JBD), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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  • Ulrika Landry,

    1. Alcohology Unit Department of Community Medicine (PG, CA, OW), Hôpitaux Universitaires de Genève, Switzerland, Programme ‘Boire moins c'est mieux’ (SA, PM), National Association for Prevention of Alcoholism, (Paris), France, Centre for Treatment in Alcohology; (UL, JBD), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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  • Cataldo Accietto,

    1. Alcohology Unit Department of Community Medicine (PG, CA, OW), Hôpitaux Universitaires de Genève, Switzerland, Programme ‘Boire moins c'est mieux’ (SA, PM), National Association for Prevention of Alcoholism, (Paris), France, Centre for Treatment in Alcohology; (UL, JBD), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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  • Sonia Arfaoui,

    1. Alcohology Unit Department of Community Medicine (PG, CA, OW), Hôpitaux Universitaires de Genève, Switzerland, Programme ‘Boire moins c'est mieux’ (SA, PM), National Association for Prevention of Alcoholism, (Paris), France, Centre for Treatment in Alcohology; (UL, JBD), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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  • Olivier Wenger,

    1. Alcohology Unit Department of Community Medicine (PG, CA, OW), Hôpitaux Universitaires de Genève, Switzerland, Programme ‘Boire moins c'est mieux’ (SA, PM), National Association for Prevention of Alcoholism, (Paris), France, Centre for Treatment in Alcohology; (UL, JBD), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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  • Jean-Bernard Daeppen

    1. Alcohology Unit Department of Community Medicine (PG, CA, OW), Hôpitaux Universitaires de Genève, Switzerland, Programme ‘Boire moins c'est mieux’ (SA, PM), National Association for Prevention of Alcoholism, (Paris), France, Centre for Treatment in Alcohology; (UL, JBD), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Reprint requests: Pascal Gache, Unité d'alcoologie, Département de Médecine Communautaire, Hôpitaux Universitaires de Genève, Rue Micheli du Crest 24, 1211 Genève 14, Suisse; E-mail: pascal.gache@hcuge.ch

Abstract

Abstract: Background: Excessive drinking is a major problem in Western countries. AUDIT (Alcohol Use Disorders Identification Test) is a 10-item questionnaire developed as a transcultural screening tool to detect excessive alcohol consumption and dependence in primary health care settings

Objectives: The aim of the study is to validate a French version of the Alcohol Use Disorders Identification Test (AUDIT)

Methods: We conducted a validation cross-sectional study in three French-speaking areas (Paris, Geneva and Lausanne). We examined psychometric properties of AUDIT as its internal consistency, and its capacity to correctly diagnose alcohol abuse or dependence as defined by DSM-IV and to detect hazardous drinking (defined as alcohol intake >30 g pure ethanol per day for men and >20 g of pure ethanol per day for women). We calculated sensitivity, specificity, positive and negative predictive values and Receiver Operator Characteristic curves. Finally, we compared the ability of AUDIT to accurately detect “alcohol abuse/dependence” with that of CAGE and MAST

Results: 1207 patients presenting to outpatient clinics (Switzerland, n= 580) or general practitioners’ (France, n= 627) successively completed CAGE, MAST and AUDIT self-administered questionnaires, and were independently interviewed by a trained addiction specialist. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥13 for males, sensitivity 70.1%, specificity 95.2%, PPV 85.7%, NPV 94.7% and for females sensitivity 94.7%, specificity 98.2%, PPV 100%, NPV 99.8%); and hazardous drinkers (with AUDIT ≥7, for males sensitivity 83.5%, specificity 79.9%, PPV 55.0%, NPV 82.7% and with AUDIT ≥6 for females, sensitivity 81.2%, specificity 93.7%, PPV 64.0%, NPV 72.0%). AUDIT gives better results than MAST and CAGE for detecting “Alcohol abuse/dependence” as showed on the comparative ROC curves

Conclusions: The AUDIT questionnaire remains a good screening instrument for French-speaking primary care.

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