Alcohol screening and assessment measures for young people

A systematic review and meta-analysis of validation studies

Paul Toner (Lead / Corresponding author), Jan Böhnke, Phil Anderson, Jim McCambridge

    Research output: Contribution to journalArticle

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    Abstract

    Background: There is a strong rationale for clinicians to identify risky drinking among young people given the harms caused by alcohol. This systematic review evaluates the quality of evidence in the validation literature on alcohol screening and assessment measures for young people under 25.

    Methods: Six electronic databases (MEDLINE; EMBASE; PsycINFO; SSCI; HMIC; ADAI) were searched in May 2016 for published and grey literature. Full-text reports published in English since 1980 were included if they aimed to validate an alcohol screening or assessment measure in comparison with a previously validated alcohol measure. Risk of bias was assessed in studies surpassing a priori quality thresholds for predictive validity, internal and test-retest reliability using COSMIN and QUADAS-2.

    Results: Thirty nine reports comprising 135 discrete validation studies were included. Summary estimates indicated that the screening instruments performed well - AUC 0.91 (95% CI: 0.88 to 0.93); sensitivity 0.98 (0.95 to 0.99); specificity 0.78 (0.74 to 0.82). Noting a paucity of validation evidence for existing assessment instruments, aggregated reliability estimates suggest a reliability of 0.81 (0.78 to 0.83) adjusted for 10 items. Risk of bias was high for both types of studies.

    Conclusions: The volume and quality of available evidence are superior for screening measures. It is recommended that clinicians use alcohol frequency or quantity items if asking a single question. If there is an opportunity to ask more questions either the 3-item AUDIT-C or the 10-item AUDIT are recommended. There is a need to develop new instruments to assess young people's alcohol-related problems.

    Original languageEnglish
    Pages (from-to)39-49
    Number of pages11
    JournalDrug and Alcohol Dependence
    Volume202
    Early online date28 Feb 2019
    DOIs
    Publication statusPublished - 1 Sep 2019

    Fingerprint

    Validation Studies
    Meta-Analysis
    Screening
    Alcohols
    Literature
    Reproducibility of Results
    MEDLINE
    Drinking
    Area Under Curve
    Databases

    Keywords

    • Alcohol
    • Assessment
    • Meta-analysis
    • Screening
    • Systematic review
    • Young people

    Cite this

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    title = "Alcohol screening and assessment measures for young people: A systematic review and meta-analysis of validation studies",
    abstract = "Background: There is a strong rationale for clinicians to identify risky drinking among young people given the harms caused by alcohol. This systematic review evaluates the quality of evidence in the validation literature on alcohol screening and assessment measures for young people under 25.Methods: Six electronic databases (MEDLINE; EMBASE; PsycINFO; SSCI; HMIC; ADAI) were searched in May 2016 for published and grey literature. Full-text reports published in English since 1980 were included if they aimed to validate an alcohol screening or assessment measure in comparison with a previously validated alcohol measure. Risk of bias was assessed in studies surpassing a priori quality thresholds for predictive validity, internal and test-retest reliability using COSMIN and QUADAS-2.Results: Thirty nine reports comprising 135 discrete validation studies were included. Summary estimates indicated that the screening instruments performed well - AUC 0.91 (95{\%} CI: 0.88 to 0.93); sensitivity 0.98 (0.95 to 0.99); specificity 0.78 (0.74 to 0.82). Noting a paucity of validation evidence for existing assessment instruments, aggregated reliability estimates suggest a reliability of 0.81 (0.78 to 0.83) adjusted for 10 items. Risk of bias was high for both types of studies.Conclusions: The volume and quality of available evidence are superior for screening measures. It is recommended that clinicians use alcohol frequency or quantity items if asking a single question. If there is an opportunity to ask more questions either the 3-item AUDIT-C or the 10-item AUDIT are recommended. There is a need to develop new instruments to assess young people's alcohol-related problems.",
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    author = "Paul Toner and Jan B{\"o}hnke and Phil Anderson and Jim McCambridge",
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    Alcohol screening and assessment measures for young people : A systematic review and meta-analysis of validation studies. / Toner, Paul (Lead / Corresponding author); Böhnke, Jan; Anderson, Phil ; McCambridge, Jim.

    In: Drug and Alcohol Dependence, Vol. 202, 01.09.2019, p. 39-49.

    Research output: Contribution to journalArticle

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    T2 - A systematic review and meta-analysis of validation studies

    AU - Toner, Paul

    AU - Böhnke, Jan

    AU - Anderson, Phil

    AU - McCambridge, Jim

    N1 - This study was funded by the Society for the Study of Addiction (SSA) who supported PT with a Griffith Edwards Academic Fellowship award to conduct the review.

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    N2 - Background: There is a strong rationale for clinicians to identify risky drinking among young people given the harms caused by alcohol. This systematic review evaluates the quality of evidence in the validation literature on alcohol screening and assessment measures for young people under 25.Methods: Six electronic databases (MEDLINE; EMBASE; PsycINFO; SSCI; HMIC; ADAI) were searched in May 2016 for published and grey literature. Full-text reports published in English since 1980 were included if they aimed to validate an alcohol screening or assessment measure in comparison with a previously validated alcohol measure. Risk of bias was assessed in studies surpassing a priori quality thresholds for predictive validity, internal and test-retest reliability using COSMIN and QUADAS-2.Results: Thirty nine reports comprising 135 discrete validation studies were included. Summary estimates indicated that the screening instruments performed well - AUC 0.91 (95% CI: 0.88 to 0.93); sensitivity 0.98 (0.95 to 0.99); specificity 0.78 (0.74 to 0.82). Noting a paucity of validation evidence for existing assessment instruments, aggregated reliability estimates suggest a reliability of 0.81 (0.78 to 0.83) adjusted for 10 items. Risk of bias was high for both types of studies.Conclusions: The volume and quality of available evidence are superior for screening measures. It is recommended that clinicians use alcohol frequency or quantity items if asking a single question. If there is an opportunity to ask more questions either the 3-item AUDIT-C or the 10-item AUDIT are recommended. There is a need to develop new instruments to assess young people's alcohol-related problems.

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    KW - Meta-analysis

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    KW - Systematic review

    KW - Young people

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