Background Alcohol Use Disorders Identification Test (AUDIT) is effective in identifying problem drinking. This study purposed to evaluate the usefulness of AUDIT in identifying problem drinking among Korean university students whose drinking characteristic is different from adults.Methods: The subjects were 235 students who had visited the Health Service Center of Chungnam National University. All subjects had a diagnostic interview for the presence of at-risk drinking and alcohol use disorder. At-risk drinking was defi ned according to the criteria of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed by the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV TR). At-risk drinking or alcohol use disorder was classified into problem drinking. At the same time, a survey was conducted using three screening tools: AUDIT, cut down, annoyed, guilty feelings, eye opener (CAGE), and cut down, under infl uence, guilty feelings, eye opener (CUGE). Area under receiver operating characteristic curve (AUROC) of the questionnaires to the results of interviews were compared. Results: Seventy one students were at-risk drinkers and 46 had alcohol use disorder, and 75 were classifi ed into problem drinkers. For identifi cation of problem drinking, AUROC of AUDIT was 0.970 in men and 0.989 in women. For CAGE, it was 0.650 in men and 0.747 in women. For CUGE, it was 0.689 in men and 0.745 in women.Conclusion: Above results suggest that AUDIT is most effective in identifying university students' problem drinking.
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Background Alcoholism screening tests are commonly used in primary medical care. This study examined how much the level of insight of alcohol-dependent patients would impact on the sensitivity of alcoholism screening tests. Methods: The sample consisted of 122 subjects who had been diagnosed with alcohol dependence and who completed Alcohol Use Disorders Identification Test (AUDIT), and CAGE questionnaire. AUDIT positive was defined as a score of 20 points or above and CAGE positive, 3 points or above. Insight level was classified as poor, fair, and good using the Hanil Alcohol Insight Scale (HAIS). Positive rates on the AUDIT and CAGE were analyzed according to the level of insight. Results: In good insight group, the sensitivity of AUDIT and CAGE identified 96.9% and 96.9% of the participants as alcohol dependence, respectively. In fair insight group, those were 92.7% and 96.4%, respectively. However, in poor insight group, these decreased substantially to 62.9% and 65.7%, respectively. After adjusting for general characteristics on the basis of good insight group, we found that the possibility of positive on the AUDIT was significantly lower in poor insight group (Odd ratios [OR], 0.025; 95% confidence interval [CI], 0.002 to 0.411). Also, the possibility of positive on the CAGE was significantly lower in poor insight group (OR, 0.016; 95% CI, 0.001 to 0.358). Conclusion: Alcohol-dependent patients with poor insight showed a high rate of false negatives in alcoholism screening tests. These suggest that primary care physicians should be careful in interpreting the results of alcoholism screening tests.
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Background : Heavy drinking may be a cause of serious health problems in hepatitis B virus carriers. The aim of this study was to reveal the degree of drinking problems in the Korean hepatitis B virus healthy carriers.
Methods : The subjects were 218 hepatitis B virus healthy carriers (124 males and 94 females) recruited from those who visited the Health Promotion Center of Chungnam National University Hospital for a general health check-up. Drinking problems of the subjects were evaluated by the AUDIT (Alcohol Use Disorders Identification Test) questionnaire.
Results : The AUDIT scores (mean±SD) of the male subjects (9.6±7.9) were significantly (P＜0.001) higher than those of the female subjects (2.7±5.2). The individuals with heavy drinking (more than 14 drinks in males and 7 drinks in females per week) are 24 (19.4%) in males and 5 (5.3%) in females. Alcohol use disorders were suspected in 36 (29.0%) males and 4 (4.3%) females.
Conclusion : It is suggested that, in Korea, clinical attention in primary health care should be focused on reducing the alcohol consumption among the hepatitis B virus carriers, considering a large proportion have drinking problems and the possible harmful effect on their health by heavy drinking.
Background : Such screening tools for alcoholism as MAST, NAST, CAGE focused on the alcohol related psychosocial problems. But some men can be excluded in a study using these tools whereas they might be at risk for alcohol-related physical problems. From this perspective the new tools focusing under quantity and frequency of intake for detection of early-stage drinkers not yet manifesting evident psychosocial problems but having alcohol-related potential harms, are being developed to provide n these aspects, 10-itemed AUDIT was developed by WHO and this study was developed to provide standard points for screening alcohol problems in Korea with cultural difference through AUDIT. Method : The subjects were 85 drinking men and 11 male alcohol dependents who visited Kangnumg hospital of Asan foundation from July until August 1998. The team composed of 2 family physicians and 1 psychiatrist, who delivered structured interviews based on DSM-IV criteria in terms of psychosocial problems, and examined them and reviewed the patient records in terms of alcohol-related physical problems. Accordingly the subjects were classified into 'normal', 'physical problems-related drinkers' without psychosocial problems, and 'alcohol abuse' and 'alcohol dependent' according to DSM-IV criteria. Aside from physicians’ diagnostic procedures, they were again made to complete a questionnaire including all the items of AUDIT, MAST, NAST and CAGE.
Results : As regards physicians' diagnostic results, 31 were normal 8 had physical problems without psychosocial problems, 36 abused alcohol, and 21 were alcohol-dependent. The mean AUDIT scores of all the subjects were 17.5(±9.5) and the mean AUDIT scores of each group were 7.1(±4.3), 16.6(±3.4), 19.9(±5.0), 29.3(±5.1), respectively and revealed significant difference among them. AUDIT scores were significantly correlated with those marked from physician's diagnostic results and also significantly correlated with MAST, NAST and CAGE, respectively. After consideration of means AUDIT scores and standard deviations of each group according to diagnostic results, the preliminary standard AUDIT problems were most possible 12,13,14 points. Their sensitivity and specificity were 96.9% and 87.1% in 12 points, 92.3 and 90.3% in 13 points, and 90.8% and 90.3% in 14 points, respectively. The preliminary standard AUDIT scores concerning 'alcohol use disorders' based on DSM-IV criteria were most possibly 14,15,16 with its sensitivity and specificity of 91.2% and 74.4% in 14 points, 89.5% and 79.5% in 15 points, and 84.2% and 84.6% in 16 points. The preliminary standard AUDIT scores for 'alcohol dependence' were most possibly 25,26,27 with its sensitivity and specificity of 85.7% and 90.7% in 25 points, 85.7% and 93.3% in 26 points, and 71.4% and 94.7% in 27 points.
Conclusion : The authors recommend AUDIT cut-off scores of 12 points as the standard value for a broader sense of 'problem drinking' including physical as well as psychosocial problems, 15 for 'alcohol use disorders' based on DSM-IV criteria, and 26 for 'alcohol dependence' in Korea.
Background : Proper management of diabetes is important in family practice. This study aimed to assess the quality of diabetes care in an outpatient department of family medicine in a general hospital.
Methods : We reviewed all the charts of patients who had a new diagnosis code of diabetes in an outptient department of family medicine at Asan medical center from January 1, 1994 to December 31, 1995. The documentation of medical history, physical examination, laboratory tests and treatments were examined. We surveyed the doctors who had managed the above patients.
Results : This study included 95 patients with diabetes. In the chart audit, history of smoking and symptoms of chronic complications of diabetes were documented in 61.1% and 33.6%, respectively. Blood pressure measurement, fundus examination and neurologic examination were done in 100.0%, 47.4% and 18.9%, respectively. Lipid profile and urine microalbumin were checked in 47.4% and 1.00%, respectively. Management of hypertension and exercise education were documented in 65.0% and 47.4%, respectively. In the doctor survey, doctors responded that they had provided services to diabetic patients more frequently than the results of chart audit except on a few items.
Conclusion : The care of diabetic patients was relatively adequate in many items, but insufficient in some items. Efforts to improve the quality of diabetes care in family practice are needed.
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