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

• Published in: Pediatrics (Evanston) Vol. 143; no. 3
• Main Authors: Linakis, James G, Bromberg, Julie R, Casper, T Charles, Chun, Thomas H, Mello, Michael J, Richards, Rachel, Mull, Colette C, Shenoi, Rohit P, Vance, Cheryl, Ahmad, Fahd, Bajaj, Lalit, Brown, Kathleen M, Chernick, Lauren S, Cohen, Daniel M, Fein, Joel, Horeczko, Timothy, Levas, Michael N, McAninch, Brett, Monuteaux, Michael C, Grupp-Phelan, Jackie, Powell, Elizabeth C, Rogers, Alexander, Suffoletto, Brian, Dean, J Michael, Spirito, Anthony
• Format: Journal Article
• Language: English
• Published: United States 01.03.2019
• Subjects: Adolescent; Alcoholism - diagnosis; Alcoholism - epidemiology; Alcoholism - therapy; Child; Emergency Service, Hospital - standards; Female; Follow-Up Studies; Humans; Male; Predictive Value of Tests; Reproducibility of Results; Risk Factors; Surveys and Questionnaires - standards; Time Factors; Underage Drinking - prevention & control
• ISSN: 1098-4275
• DOI: 10.1542/peds.2018-2001

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). Participants ( = 4834) completed a baseline assessment battery. A subsample of participants completed the battery at 1, 2, and 3 years follow up. 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 ( = .0002), 2 years ( <.0001), and 3 years ( = .0005), as were the differences between moderate- and highest-risk drinkers at 1 and 2 years ( < .0001 and = .0088, respectively) but not at 3 years ( = .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 diagnosis. The NIAAA 2-question screen can accurately characterize adolescent risk for future AUDs. Future studies are needed to determine optimaluse of the screen.