![]() The CAGE questions have also achieved widespread use. 13 Among adolescents, however, AUDIT lacks sufficient sensitivity to make its use practical. 11 - 13 The AUDIT is a 10-item questionnaire that has been found to be sensitive and specific for predicting current hazardous use of alcohol and, to a slightly lesser extent, lifetime diagnosis of alcohol dependence. In recent years, the Alcohol Use Disorders Identification Test (AUDIT) has become widely known and used. Several brief screening tests have been developed for use among adults. The first step in formalizing a clinical management strategy must be the development of a practical screening tool. ![]() Development of a brief and effective method for AOD screening, assessment, and intervention may therefore substantially improve practices among pediatricians. Pediatricians may lack sufficient training or be reluctant to initiate screening for a problem that they believe is both difficult to treat and time-consuming to assess. 10 The reasons for this low level of compliance are unknown. and make an assessment as to whether additional counseling or referral may be needed." 9 However, surveys of practicing pediatricians indicate that fewer than half actually perform such a screening. alcohol and other drug use among their patients. A policy statement recently published by the American Academy of Pediatrics Committee on Substance Abuse states that pediatricians should be "able to evaluate the nature and extent of. 5, 6Īccording to the American Medical Association's Guidelines for Adolescent Preventive Services (GAPS) 7 and the Maternal and Child Health Bureau's Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 8 every adolescent should be screened for use of alcohol or other drugs (AOD) as part of routine health care. 4 This is particularly concerning as motor vehicle crashes are the leading cause of death among young people, and a significant proportion are directly related to the use of alcohol. 4 Even more alarming, 38.8% of surveyed students in grades 9 through 12 reported riding in a car with a driver who had been drinking. 2, 3 Thirty-two percent of high school students binge drink (≥5 drinks in a row) and 15.4% drive after drinking. 1 Recent epidemiological data indicate drug use by students in grades 8 through 12 has risen significantly since 1990, and adolescents are beginning to drink at younger ages. ![]() SUBSTANCE USE and abuse has been considered the number 1 health problem in the United States. However, CRAFFT seems promising as a brief AOD screening test. The 6 items were arranged into a mnemonic (CRAFFT).Ĭonclusions Further research must confirm the test's psychometric properties in a general clinic population. Two or more yes answers had a sensitivity of 92.3% and specificity of 82.1% for intensive AOD treatment need. This model correctly classified 86% of subjects according to the PICS criteria. Stepwise linear regression analysis identified 6 items whose total combined score was highly correlated with PICS (Pearson r=0.84, P<.01). The 9 items had good internal consistency (Cronbach α=.79). Results Ninety-nine adolescents were tested (70.7% female, 36.4% black, 32.3% white, 19.2% Hispanic, mean age, 16.3 years). Sensitivity and specificity rates for predicting a PICS T score of 55 or higher were calculated from 2 × 2 tables. The PICS T score has been shown to correctly classify substance abuse treatment need as no treatment (T<35), brief office intervention (T=35-40), outpatient or short-term treatment (T=41-54), and inpatient or long-term treatment (T≥55). The relationship between the brief screen and PICS raw score was determined by stepwise linear regression analysis. Measures Internal consistency of the 9 items was calculated using the Cronbach α. Subjects Fourteen- to 18-year-old patients consecutively arriving for routine medical care who were known to have used AOD. Setting A hospital-based adolescent clinic. Methods A 9-item test was constructed by combining and modifying items from several AOD assessments, and administered concurrently with the Personal Involvement With Chemicals Scale (PICS), the criterion standard. Objective To develop a brief alcohol and other drug (AOD) screening test for adolescents. ![]() Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment. ![]()
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