TY - JOUR
T1 - Auditing the AUDIT
T2 - A systematic review of cut-off scores for the Alcohol Use Disorders Identification Test (AUDIT) in low- and middle-income countries
AU - Nadkarni, Abhijit
AU - Garber, Alison
AU - Costa, Sheina
AU - Wood, Sheena
AU - Kumar, Sonali
AU - MacKinnon, Nathalie
AU - Ibrahim, Mariam
AU - Velleman, Richard
AU - Bhatia, Urvita
AU - Fernandes, Godwin
AU - Weobong, Benedict
AU - Rane, Anil
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Introduction: The World Health Organization's (WHO) Alcohol Use Disorders Identification Test (AUDIT) is used extensively across the world, with cut-off scores recommended by the WHO. We reviewed the use and validity of AUDIT cut-off scores in low- and middle-income countries as cultural contexts are expected to influence the detection of alcohol use disorders. Materials and methods: The systematic review was guided by an a priori defined protocol consistent with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. We searched Cochrane library, Medline, EMBASE, PsycINFO, CINAHL, Indmed, LILACS, and AJOL databases using appropriate search terms. We conducted a narrative synthesis of the data. Results: We identified 54 distinct studies that used AUDIT cut-off scores which were not in alignment with those recommended by the WHO. India (n = 10), Nigeria (n = 9), and Brazil (n = 9) produced most of these included studies. Most of the studies (n = 42) did not conduct psychometric evaluations of AUDIT cut-off scores. Of the twelve studies which did report psychometric results, a wide range of cut-off scores performed well. In these studies the cut-off scores to detect hazardous drinking ranged from >3 to >5, for harmful drinking from >5 to >16, and for dependent drinking from >7 to >24. Discussion: AUDIT is being widely used in LMICs and non-recommended cut-off scores are considered to be appropriate in these countries. It is important to systematically evaluate the psychometric properties of those cut-off scores to ensure the internal validity of the studies in which they are used.
AB - Introduction: The World Health Organization's (WHO) Alcohol Use Disorders Identification Test (AUDIT) is used extensively across the world, with cut-off scores recommended by the WHO. We reviewed the use and validity of AUDIT cut-off scores in low- and middle-income countries as cultural contexts are expected to influence the detection of alcohol use disorders. Materials and methods: The systematic review was guided by an a priori defined protocol consistent with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. We searched Cochrane library, Medline, EMBASE, PsycINFO, CINAHL, Indmed, LILACS, and AJOL databases using appropriate search terms. We conducted a narrative synthesis of the data. Results: We identified 54 distinct studies that used AUDIT cut-off scores which were not in alignment with those recommended by the WHO. India (n = 10), Nigeria (n = 9), and Brazil (n = 9) produced most of these included studies. Most of the studies (n = 42) did not conduct psychometric evaluations of AUDIT cut-off scores. Of the twelve studies which did report psychometric results, a wide range of cut-off scores performed well. In these studies the cut-off scores to detect hazardous drinking ranged from >3 to >5, for harmful drinking from >5 to >16, and for dependent drinking from >7 to >24. Discussion: AUDIT is being widely used in LMICs and non-recommended cut-off scores are considered to be appropriate in these countries. It is important to systematically evaluate the psychometric properties of those cut-off scores to ensure the internal validity of the studies in which they are used.
KW - Alcohol Use Disorders Identification Test (AUDIT)
KW - Alcohol use disorders
KW - Low- and middle-income countries
KW - Psychometrics
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85069733646&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2019.04.031
DO - 10.1016/j.drugalcdep.2019.04.031
M3 - Article
C2 - 31349205
AN - SCOPUS:85069733646
SN - 0376-8716
VL - 202
SP - 123
EP - 133
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
ER -