Poor Sensitivity for Clinician Suspicion of Alcohol Problem

(HealthDay News) – Primary care physicians’ clinical suspicion of an alcohol problem has high specificity, but poor sensitivity, according to research published in the January/February issue of the Annals of Family Medicine.

To evaluate the sensitivity, specificity, and predictive values of clinician suspicion compared with screening-detected alcohol problems in patients, Daniel C. Vinson, MD, MSPH, of the University of Missouri in Columbia, and colleagues conducted a cross-sectional study involving 1,669 patients visiting 94 primary care clinicians’ offices.

The researchers found that, using a validated screening instrument, 10.1% of patients (171) screened positive for hazardous drinking and 3.8% (64) were positive for harmful drinking. Based on clinical suspicion, 81 patients were identified as having alcohol problems (hazardous drinking, 37; harmful drinking, 40; both, four). The sensitivity and specificity of clinical suspicion of hazardous or harmful drinking were 27% and 98%, respectively. The positive predictive value was 62% and the negative predictive value was 92%.

“Our study affirms that systems need to be in place, possibly through team-based care, to screen systematically for alcohol problems with a validated question or series of questions and to address this health threat using evidence-based approaches,” the authors write. “This process can improve patient health and perhaps save some of the $223 billion economic cost of alcohol in the United States (in 2006).”

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