Effectiveness of the AUDIT-C as a Screening Test for Alcohol Misuse in Three Race/Ethnic Groups
Open accessAbstract
Background The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) is a brief validated screen for risky drinking and alcohol abuse and dependence (alcohol misuse). However, the AUDIT-C was validated in predominantly White populations, and its performance in different racial/ethnic groups is unclear.Objective To evaluate the validity of the AUDIT-C among primary care patients from the predominant racial/ethnic subgroups within the United States: White, African American, and Hispanic.Design Cross-sectional interview validation study.Participants 1,292 outpatients from an academic family practice clinic in Texas (90% of randomly sampled eligible).Measurements and main results Race/ethnicity was self-reported. Areas under the receiver operating curve (AuROCs) evaluated overall AUDIT-C performance in the 3 racial/ethnic groups compared to diagnostic interviews for alcohol misuse. AUDIT-C sensitivities and specificities at recommended screening thresholds were compared across racial/ethnic groups. AuROCs were greater than 0.85 in all 3 groups, with no significant differences across racial/ethnic groups in men (P = .43) or women (P = .12). At previously recommended cut points, there were statistically significant differences by race in AUDIT-C sensitivities but not specificities. In women, the sensitivity was higher in Hispanic (85%) than in African-American (67%; P = .03) or White (70%; P = .04) women. In men, the sensitivity was higher in White (95%) than in African-American men (76%; P = .01), with no significant difference from Hispanic men (85%; P = .11).Conclusions The overall performance of the AUDIT-C was excellent in all 3 racial/ethnic groups as reflected by high AuROCs. At recommended cut points, there were significant differences in the AUDIT-C's sensitivity but not in specificity across the 3 racial/ethnic groups.
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The AUDIT-C is the best practice tool currently recommended for alcohol screening in the general population and performs well for adolescents and across ethnic groups.
“The AUDIT-C is a shortened version of the AUDIT [47], which is the best practice tool currently recommended for alcohol screening in the general population and performs well for adolescents [48,49] and across ethnic groups [50].”
From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [50]
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“The AUDIT-C is a shortened version of the AUDIT [47], which is the best practice tool currently recommended for alcohol screening in the general population and performs well for adolescents [48,49] and across ethnic groups [50].”
- Authors
- Frank, D., DeBenedetti, A. F., Volk, R. J., Williams, E. C., Kivlahan, D. R., & Bradley, K. A.
- Affiliations
- VA Puget Sound Health Care System (US)
- Baylor College of Medicine (US)
- University of Washington (US)
- Corresponding author
- Frank, Danielle
- Venue
- Journal of General Internal Medicine
- Published
- 2008-04-18
- Volume
- 23
- Issue
- 6
- Pages
- 781-787
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2517893
- OpenAlex
- W2029905732
- Cited by
- 336
- References
- 46
- Citations by year
- 2026: 15 · 2025: 26 · 2024: 22 · 2023: 31 · 2022: 26 · 2021: 24 · 2020: 26 · 2019: 19 · 2018: 22 · 2017: 20 · 2016: 16 · 2015: 17 · 2014: 18 · 2013: 16 · 2012: 5
- FWCI
- 8.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R21AA014672)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- AUDIT-C, alcohol misuse screening, racial and ethnic differences, African American patients, Hispanic patients, Caucasian patients, screening sensitivity and specificity, primary care, general practice, alcoholism
- MeSH terms
- Adolescent, Adult, Aged, Alcohol Drinking, Black or African American, Cross-Sectional Studies, Female, Hispanic or Latino, Humans, Male, Mass Screening, Middle Aged, Surveys and Questionnaires, Sensitivity and Specificity, Alcohol-Related Disorders, White People
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