Primary Publications

Publication Date Language Abstracts Access
Aasland, O.G., Amundsen, A., Bovim, G., Fauske, S., Mørland, J.
Identification of patients at risk of alcohol related damage [Identifisering av pasienter med risiko for alkoholskader.] Tidsskrift for den Norske laegeforening
Volume 110, Issue 12, 10 May 1990, Pages 1523-1527
1990 Norwegian Alcohol is clearly underestimated as an etiological factor in clinical medicine. A number of acute and chronic medical conditions are related to alcohol consumption, even when there are no signs of alcohol dependence. This article describes a new screening instrument proposed and developed by the WHO, AUDIT (Alcohol Use Disorders Identification Test), to be used in hospitals and general medical settings. The clinical component of this instrument is based on analyses of regular patients where the level of consumption was used as the dependent variable. This makes it possible to assess the extent and risk of alcohol-related problems without actually discussing alcohol with the patient. The alcohol-specific component can be used for a more detailed exploration of the patient's use of alcohol. Via Publisher
Babor T.F., de la Fuente J.R., Saunders J.B. and Grant M.
AUDIT. The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care. Geneva: World Health Organization, 1992.
1992 English This manual describes a screening procedure called AUDIT, the Alcohol Use Disorders Identification Test. The AUDIT procedure was developed by the World Health Organization to identify persons whose alcohol consumption has become hazardous or harmful to their health. Because alcohol use poses health risks and causes a variety of health problems, systematic screening by health care workers is likely to contribute to preventive medicine. By way of introducing AUDIT, this manual describes:
- the advantages of screening for alcohol problems;
- how AUDIT was developed;
- applications of AUDIT to the early identification of alcohol-related problems;
- scoring and interpretation of AUDIT.
Open Access
Babor TF, Higgins-Biddle JC, Saunders JB and Monteiro M.
AUDIT. The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. Geneva: World Health Organization, 2001 (Second Edition).
2001 English Distributed with "Brief intervention for hazardous and harmful drinking : a manual for use in primary care" in one folder entitled "Screening and brief intevention for alcohol problems in primary care". The first edition of this manual was published in 1989 (‎document no. WHO/MNH/DAT/89.4)‎ and was subsequently updated in 1992 (‎WHO/PSA/92.4)‎ Open Access
Bohn, M.J., Babor, T.F., Kranzler, H.R.
The Alcohol Use Disorders Identification Test (AUDIT): Validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol, Volume 56, Issue 4, 1995, Pages 423-432
1995 English Objective: The concurrent, construct, and discriminant validity of the Alcohol Use Disorders Identification Test (AUDIT) were evaluated. AUDIT consists of a 10-item Core questionnaire and an 8-item Clinical procedure. AUDIT was designed to identify hazardous drinkers (whose drinking increases their risk of alcohol-related problems, though alcohol-associated harm has not yet occurred); harmful drinkers (who have had recent physical or mental harm from their drinking, but who are not alcohol-dependent); and people with alcohol dependence.Conclusions: The AUDIT Core Instrument is useful for early detection of hazardous or harmful drinking, while the AUDIT Clinical Instrument is better applied to identification and/or confirmation of cases of alcohol dependence. Via Publisher
Conigrave K.M., Hall W.D. and Saunders J.B.
The AUDIT questionnaire: choosing a cut-off score. Addiction. 1995; 90: 1349-1356
1995 English The Alcohol Use Disorders Identification Test (AUDIT) is a 10–item questionnaire designed by the World Health Organization to screen for hazardous alcohol intake in primary health care settings. In this longitudinal study we examine its performance in predicting alcohol‐related harm over the full range of its scores using receiver operating characteristic analyses. Three hundred and thirty ambulatory care patients were interviewed using a detailed assessment schedule which included the AUDIT questions. After 2‐3 years, subjects were reviewed and their experience of alcohol‐related medical and social harm assessed by interview and perusal of medical records. A UDIT was a good predictor of both alcohol‐related social and medical problems. Cut‐off points of 7‐8 maximized discrimination in the prediction of trauma and hypertension. Higher cut‐offs (12 and 22) provided better discrimination in the prediction of alcohol‐related social problems and of liver disease or gastrointestinal bleeding, but high specificity was offset by reduced sensitivity. We conclude that the recommended cut‐off score of eight is a reasonable approximation to the optimal for a variety of endpoints. Via Publisher
Conigrave K.M., Saunders J.B. and Reznik R.B.
Predictive capacity of the AUDIT questionnaire for alcohol related harm. Addiction, 1995; 90:1479-1485.
1995 English The Alcohol Use Disorders Identification Test (AUDIT) is a 10‐item questionnaire designed to screen for hazardous and harmful alcohol consumption. We examined its ability to predict alcohol‐related illness and social problems, hospital admission and mortality over a 2–3‐year period. We conclude that A UDIT should prove a valuable tool in screening for hazardous and harmful alcohol consumption so that intervention can be provided to those at particular risk of adverse consequences. Via Publisher
Hall W, Saunders, JB, Babor TF, Aasland OG, Amundsen A, Hodgson R, Grant M.
The structure and correlates of alcohol dependence : WHO collaborative project on the early detection of persons with harmful alcohol consumption – III. Addiction. Volume 88, Issue 12, December 1993, Pages 1627-1636
1993 English The cross‐cultural validity of the Alcohol Dependence Syndrome was tested on 13 symptoms of alcohol dependence which were assessed as part of a WHO collaborative study of the early detection of harmful drinking. The subjects were drinking patients in health care settings in Australia, Bulgaria, Kenya, Mexico, Norway, and the US. Principal Components Analyses were performed on the symptoms in each centre, and the degree of agreement between the results was assessed by calculating coefficients of congruence between the item loadings on the first principal component. In all six centres the first Principal Component accounted for at least half of the total variance and all symptoms had positive loadings greater than 0.40 on the first Principal Component. The coefficients of congruence were all 0.98 or more, and the 13 symptoms had internal consistency coefficients of 0.94 or more. An alcohol dependence score defined by the sum of positive responses to the 13 alcohol dependence symptoms was positively correlated with self‐reported alcohol consumption, alcohol‐related problems, serum gamma glutamyltransferase and a clinical examination assessment of alcoholism in all six samples. Via Publisher
Saunders JB and Aasland OG.
WHO Collaborative Project on Identification and Treatment of Persons with Harmful Alcohol Consumption. Report on Phase I. Development of a Screening Instrument. Geneva: World Health Organization, 1987.
1987 English Open Access
Saunders JB, Aasland OG, Amundsen A and Grant M.
Alcohol consumption and related problems among primary health care patients: WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption I. Addiction. Volume 88, Issue 3, March 1993, Pages 349-362
1993 English This WHO collaborative project is the first phase of a programme of work aimed at developing techniques for early identification and treatment of persons with hazardous and harmful alcohol consumption. The aim of the present study was to determine the prevalence of hazardous and harmful alcohol use among patients attending primary health care facilities in several countries, and to examine the correlates of drinking behaviour and alcohol‐related problems in these culturally diverse populations. The broader purpose was to determine whether there was justification for developing alcohol screening instruments for cross‐national use. One thousand, eight hundred and eighty‐eight subjects in Australia, Bulgaria, Kenya, Mexico, Norway and the USA underwent a comprehensive assessment of their medical history, alcohol intake, drinking practices, and any physical or psychosocial problems related to alcohol. After non‐drinkers and known alcoholics had been excluded, 18% of subjects had a hazardous level of alcohol intake and 23% had experienced at least one alcohol‐related problem in the previous year. Intrascale reliability coefficients were uniformly high for the drinking behaviour (dependence) and adverse psychological reactions scales, and moderately high for the alcohol‐related problems scales. There were strong correlations between the various alcohol‐specific scales, and between these scales and measures of alcohol intake. Although the prevalence of hazardous and harmful alcohol consumption varied from country to country, there was a high degree of commonality in the structure and correlates of drinking behaviour and alcohol‐related problems. These findings strengthen the case for developing international screening instruments for hazardous and harmful alcohol consumption Via Publisher
Saunders JB, Aasland OG, Babor TF, de la Fuente JR and Grant M.
Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption II. Addiction 1993; 88:791-804.
1993 English The Alcohol Use Disorders Identification Test (A UDIT) has been developed from a six‐country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is a 10‐item questionnaire which covers the domains of alcohol consumption, drinking behaviour, and alcohol‐related problems. Questions were selected from a 150‐item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities) on the basis of their representativeness for these conceptual domains and their perceived usefulness for intervention. Responses to each question are scored from 0 to 4, giving a maximum possible score of 40. Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non‐hazardous consumption had a score of less than 8. AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross‐national study. Copyright © 1993, Wiley Blackwell. All rights reserved Via Publisher