Systematic and Other Reviews

Publication Date Language Abstracts Access
Allen, J.P., Litten, R.Z., Fertig, J.B., Babor, T.
A review of research on the Alcohol Use Disorders Identification Test (AUDIT). Alcoholism: Clinical and Experimental Research, Volume 21, Issue 4, 1997, Pages 613-619
1997 English Research on the core version of the Alcohol Use Disorders Identifi- cation Test (AUDIT) is reviewed. Sensitivities and specificities of the AUDIT for criteria of current hazardous use and, to a slightly lesser extent, lifetime alcohol dependence are high. In general, AUDIT scores are at least moderately related to other self-report alcohol screening tests. Several studies also show them as correlated with biochemical measures of drinking. Results of the AUDIT have also been associated with more distal indicators of problematic drinking. Indices of internal consistency, including Cronbach's (Y and item- total correlations, are generally in the 0.80's. Future directions for research on the AUDIT are suggested. Via Publisher
Allen, J.P., Reinert, D.F., Volk, R.J.
The Alcohol Use Disorders Identification Test: An aid to recognition of alcohol problems in primary care patients. Preventive Medicine, Volume 33, Issue 5, 2001, Pages 428-433
2001 English Background. Misuse of alcohol is associated with a range of medical problems. Fortunately, a simple pencil-and-paper measure, the Alcohol Use Disorders Identification Test, can effectively and efficiently screen for early-stage alcohol abuse as well as provide the physician information that can assist in brief intervention. Objective. The objective of this article is to briefly summarize research published on the Alcohol Use Disorders Identification Test and suggest its potential role in brief intervention in primary care settings. Methods. Scientific literature on the Alcohol Use Dis orders Identification Test through 2000 was reviewed and synthesized to address issues relevant to use of the test in primary health care settings. Results. The Alcohol Use Disorders Identification Test is quite sensitive and specific and compares favorably with alternative self-report screens for alcohol problems. Via Publisher
Haroon, S., Wooldridge, D., Hoogewerf, J., (...), Martino, L., Bhala, N.
Information standards for recording alcohol use in electronic health records: Findings from a national consultation. BMC Medical Informatics and Decision Making, Volume 18, Issue 1, 7 June 2018, Article number 36
2018 English Background: Alcohol misuse is an important cause of premature disability and death. While clinicians are recommended to ask patients about alcohol use and provide brief interventions and specialist referral, this is poorly implemented in routine practice. We undertook a national consultation to ascertain the appropriateness of proposed standards for recording information about alcohol use in electronic health records (EHRs) in the UK and to identify potential barriers and facilitators to their implementation in practice. Methods: A wide range of stakeholders in the UK were consulted about the appropriateness of proposed information standards for recording alcohol use in EHRs via a multi-disciplinary stakeholder workshop and online survey. Responses to the survey were thematically analysed using the Consolidated Framework for Implementation Research. Results: Thirty-one stakeholders participated in the workshop and 100 in the online survey. This included patients and carers, healthcare professionals, researchers, public health specialists, informaticians, and clinical information system suppliers. There was broad consensus that the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-Consumption (AUDIT-C) questionnaires were appropriate standards for recording alcohol use in EHRs but that the standards should also address interventions for alcohol misuse. Stakeholders reported a number of factors that might influence implementation of the standards, including having clear care pathways and an implementation guide, sharing information about alcohol use between health service providers, adequately resourcing the implementation process, integrating alcohol screening with existing clinical pathways, having good clinical information systems and IT infrastructure, providing financial incentives, having sufficient training for healthcare workers, and clinical leadership and engagement. Implementation of the standards would need to ensure patients are not stigmatised and that patient confidentiality is robustly maintained. Conclusions: A wide range of stakeholders agreed that use of AUDIT-C and AUDIT are appropriate standards for recording alcohol use in EHRs in addition to recording interventions for alcohol misuse. The findings of this consultation will be used to develop an appropriate information model and implementation guide. Further research is needed to pilot the standards in primary and secondary care. Open Access
Higgins-Biddle, J.C., Babor, T.F.
A review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United States: Past issues and future directions. American Journal of Drug and Alcohol Abuse, Volume 44, Issue 6, 2 November 2018, Pages 578-586
2018 English Background. The US Preventive Services Task Force recommends that clinicians screen all adults for alcohol misuse and provide brief counseling to those engaged in risky or hazardous drinking. The World Health Organization's (WHO's) Alcohol Use Disorders Identification Test (AUDIT) is the most widely tested instrument for screening in primary health care. Objectives. This paper describes the structural and functional features of the AUDIT and methodological problems with the validation of the alcohol consumption questions (AUDIT-C). The content, scoring, and rationale for a new version of the AUDIT(called the USAUDIT), adapted to US standard drink size and hazardous drinking guidelines, is presented. Method. Narrative review focusing on the consumption elements of the AUDIT. Four studies of the AUDIT-C are reviewed and evaluated. Results. The AUDIT has been used extensively in many countries without making the changes in the first three consumption questions recommended in the AUDIT User’s Manual. As a consequence, the original WHO version is not compatible with US guidelines and AUDIT scores are not comparable with those obtained in countries that have different drink sizes, consumption units, and safe drinking limits. Clinical and Scientific Significance. The USAUDIT has adapted the WHO AUDIT to a 14 g standard drink, and US low-risk drinking guidelines. These changes provide greater accuracy in measuring alcohol consumption than the AUDIT-C. Open Access
Monteiro, M.G., Gomel, M.
World Health Organization project on brief interventions for alcohol-related problems in primary health care settings. Journal of Substance Use, Volume 3, Issue 1, 1998, Pages 5-9
1998 English This paper presents an overview of the development and implementation of a brief intervention for harmful alcohol use in primary care settings by the World Health Organization. It started with the development of a valid, reliable and suitable clinical screening instrument to identify persons with early alcohol problems, a 10-item questionnaire called ''AUDIT'' (Alcohol Use Disorders, Identification Test). This was followed by a randomized clinical trial of brief intervention in primary health care settings for those who screened positive on the AUDIT. Phase III of the project studied strategies to increase the uptake and utilization of a brief intervention package by general practitioners in several countries. The next phase of the project will focus on an effective implementation and dissemination strategy in primary care settings Via Publisher
Reinert, D.F., Allen, J.P.
The Alcohol Use Disorders Identification Test: An update of research findings. Alcoholism: Clinical and Experimental Research. , 2007, Vol.31(2), p.185-199
2007 English Background: The Alcohol Use Disorders Identification Test (AUDIT) has been extensively researched to determine its capability to accurately and practically screen for alcohol problems. Methods: During the 5 years since our previous review of the literature, a large number of additional studies have been published on the AUDIT, abbreviated versions of it, its psychometric properties, and the applicability of the AUDIT for a diverse array of populations. The current article summarizes new findings and integrates them with results of previous research. It also suggests some issues that we believe are particularly in need of further study.. Conclusions: Research continues to support use of the AUDIT as a means of screening for the spectrum of alcohol use disorders in various settings and with diverse populations. Open Access
Reinert, D.F., Allen, J.P.
The Alcohol Use Disorders Identification Test (AUDIT): a review of recent research. Alcoholism: Clinical and Experimental Research, Volume 26, Issue 2, 2002, Pages 272-279
2002 English Efficient, inexpensive screening for early stage alcohol problems is important in health care settings. The Alcohol Use Disorders Identification Test (AUDIT) has been studied extensively to establish its value in this regard. Methods: A literature search that used EtOH as a database was conducted to identify studies published on the AUDIT through September 2001. Keywords used for the search were “Alcohol Use Disorders Identification Test” and “AUDIT.” All studies reporting psychometric properties of the measure were reviewed with particular attention being given to the period 1996 and later. A small number of additional references were located by noting their citation in other studies reviewed. Conclusions: Recent research continues to support use of the AUDIT as a means of screening for alcohol use disorders in health care settings in the United States. Via Publisher
Saunders, J.B., Lee, N.K.
Hazardous alcohol use: Its delineation as a subthreshold disorder, and approaches to its diagnosis and management. Comprehensive Psychiatry, Volume 41, Issue 2, 2000, Pages 95-103
2000 English The last 20 years have seen a significant paradigm shift in how we view alcohol misuse. The dichotomous model of “alcoholism” and “normal drinking” has now been replaced by the concept of a spectrum of disorders. In this new framework, “hazardous alcohol use” is defined as a repeated pattern of drinking that confers the risk of harmful consequences. It is a typical example of a subthreshold disorder. Where actual physical or psychological harm or social problems have occurred, the terms “harmful alcohol use” and “alcohol abuse,” respectively, are applied. These conditions would typically be considered to be above the clinical threshold. The most severe disorder, alcohol dependence, is a psychobiological syndrome with often severe physical, psychological, and social sequelae. This article describes how the concept of hazardous alcohol use originated, and reviews the intervention techniques that have been developed to induce and assist hazardous drinkers to reduce their consumption to nonhazardous levels. The findings from a series of World Health Organization (WHO) collaborative studies on brief interventions for hazardous alcohol use are described. This work has resulted in the development of the Alcohol Use Disorders Identification Test (AUDIT) screening instrument, which can detect over 90% of hazardous drinkers in a range of settings, and the demonstration that 5 minutes' structured advice can reduce hazardous consumption by 30%. The later phases of this program of work have examined strategies to promote the dissemination of brief interventions for hazardous alcohol use throughout primary health care, and the nationwide, systematic, and sustained utilization of these interventions. Via Publisher