Alcohol and Alcoholism Advance Access originally published online on August 22, 2005
Alcohol and Alcoholism 2005 40(6):578-583; doi:10.1093/alcalc/agh198
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THE USE OF AUDIT TO ASSESS LEVEL OF ALCOHOL PROBLEMS IN RURAL VIETNAM
1 Faculty of Public Health, Hanoi Medical University, Vietnam, 2 Department of Social Medicine, Gothenburg University, Sweden, 3 Department of Public Health Science, Karolinska Institutet, Sweden and 4 Department of Science and Training, Ministry of Health, Vietnam
* Author to whom correspondence should be addressed at: Department of Public Health Sciences, Norrbacka, Karolinska Instituet, SE-171 76 Stockholm, Sweden. E-mail: Peter.Allebeck{at}phs.ki.se
(Received 22 June 2005; first review notified 06 July 2005; in revised form 21 July 2005; accepted 26 July 2005)
Aims: To assess the accuracy and performance of AUDIT in detecting alcohol problems, as defined by ICD-10 and DSM-IV, in a rural district in Vietnam. Methods: The study was conducted in a rural district of Vietnam. Five hundred men and women aged 1860 were randomly selected for interview with AUDIT and CIDI 2.1. The ICD-10 and DSM-IV criteria for harmful use/alcohol abuse and alcohol dependence were used to evaluate AUDIT. Results: Due to few cases of alcohol problems observed among women (1/282), we could only evaluate the validity of AUDIT in men. At cut-off point 7/8, AUDIT had a sensitivity of 81.8% and a specificity of 76.1% for detecting at-risk drinking. At this cut-off point, using ICD-10 criteria, the sensitivity was 100% for harmful use and 93.8% for alcohol dependence; the specificity was 69.9% for harmful use and 87.4% for alcohol dependence. The area under the ROC curve was 0.91 (0.840.98) for harmful use and 0.84 (0.740.94) for alcohol dependence (ICD-10). The agreement between ICD-10 and DSM-IV was higher for diagnosing alcohol dependence than alcohol abuse (Kappa coefficient: 0.98 vs 0.68). Conclusion: We confirmed that AUDIT is feasible to use in a rural community in a developing country. Different cut-off points are appropriate for different purposes, but for general population screening of at-risk drinking we found a cut-off point 7/8 to be optimal.