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. 2019 Mar;143(3):e20182001.
doi: 10.1542/peds.2018-2001. Epub 2019 Feb 19.

Predictive Validity of a 2-Question Alcohol Screen at 1-, 2-, and 3-Year Follow-up

James G Linakis  1   2 , Julie R Bromberg  1   2 , T Charles Casper  3 , Thomas H Chun  1   2 , Michael J Mello  1   2 , Rachel Richards  3 , Colette C Mull  4   5 , Rohit P Shenoi  6 , Cheryl Vance  7 , Fahd Ahmad  8 , Lalit Bajaj  9 , Kathleen M Brown  10 , Lauren S Chernick  11 , Daniel M Cohen  12 , Joel Fein  13 , Timothy Horeczko  14 , Michael N Levas  15 , Brett McAninch  16 , Michael C Monuteaux  17 , Jackie Grupp-Phelan  18 , Elizabeth C Powell  19 , Alexander Rogers  20 , Brian Suffoletto  16 , J Michael Dean  3 , Anthony Spirito  1 ; Pediatric Emergency Care Applied Research Network
Affiliations

Predictive Validity of a 2-Question Alcohol Screen at 1-, 2-, and 3-Year Follow-up

James G Linakis et al. Pediatrics. 2019 Mar.

Abstract

Background: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question screen 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 follow-up, 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.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
ROC curve for the NIAAA 2-question screen when predicting DSM-5 diagnoses at follow-up. NPV, net present value; PPV, positive predictive value.
See this image and copyright information in PMC

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References

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