Predictive validity of a 2-question alcohol screen at 1-, 2-, and 3-year follow-up

James G. Linakis, Julie R. Bromberg, T. Charles Casper, Thomas H. Chun, Michael J. Mello, Rachel Richards, Colette C. Mull, Rohit P. Shenoi, Cheryl Vance, Fahd Ahmad, Lalit Bajaj, Kathleen M. Brown, Lauren S. Chernick, Daniel M. Cohen, Joel Fein, Timothy Horeczko, Michael N. Levas, Brett McAninch, Michael C. Monuteaux, Jackie Grupp-PhelanElizabeth C. Powell, Alexander Rogers, Brian Suffoletto, J. Michael Dean, Anthony Spirito

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Abstract

BACKGROUND: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question screen abstract is a valid adolescent alcohol screening tool. No studies have examined if this tool predicts future alcohol problems. We conducted a study at 16 pediatric emergency departments to determine the tool's predictive validity for alcohol misuse and alcohol use disorders (AUDs). METHODS: Participants (N = 4834) completed a baseline assessment battery. A subsample of participants completed the battery at 1, 2, and 3 years follow up. RESULTS: Of the 2209 participants assigned to follow-up, 1611 (73%) completed a 1-year followup, 1591 (72%) completed a 2-year follow-up, and 1377 (62%) completed a 3-year follow-up. The differences in AUDs between baseline NIAAA screen nondrinkers and lower-risk drinkers were statistically significant at 1 year (P = .0002), 2 years (P, .0001), and 3 years (P = .0005), as were the differences between moderate-and highest-risk drinkers at 1 and 2 years (P, .0001 and P = .0088, respectively) but not at 3 years (P = .0758). The best combined score for sensitivity (86.2% at 1 year, 75.6% at 2 years, and 60.0% at 3 years) and specificity (78.1% at 1 year, 79.2% at 2 years, and 80.0% at 3 years) was achieved by using "lower risk" and higher as a cutoff for the prediction of a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis. CONCLUSIONS: The NIAAA 2-question screen can accurately characterize adolescent risk for future AUDs. Future studies are needed to determine optimaluse of the screen.

Original languageEnglish (US)
Article numbere20182001
JournalPediatrics
Volume143
Issue number3
DOIs
StatePublished - Mar 1 2019

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Linakis, J. G., Bromberg, J. R., Casper, T. C., Chun, T. H., Mello, M. J., Richards, R., Mull, C. C., Shenoi, R. P., Vance, C., Ahmad, F., Bajaj, L., Brown, K. M., Chernick, L. S., Cohen, D. M., Fein, J., Horeczko, T., Levas, M. N., McAninch, B., Monuteaux, M. C., ... Spirito, A. (2019). Predictive validity of a 2-question alcohol screen at 1-, 2-, and 3-year follow-up. Pediatrics, 143(3), [e20182001]. https://doi.org/10.1542/peds.2018-2001