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Jonas DE, Garbutt JC, Brown JM, et al. Screening, Behavioral Counseling, and Referral in Primary Care To Reduce Alcohol Misuse [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jul. (Comparative Effectiveness Reviews, No. 64.)
This publication is provided for historical reference only and the information may be out of date.
Screening, Behavioral Counseling, and Referral in Primary Care To Reduce Alcohol Misuse [Internet].
Show detailsInstrument Name | Description | No. Items/ Questions Time to Administer | Scoring Notes |
---|---|---|---|
ARPS | Includes items in the following: domains: presence of medical and psychiatric conditions (14 items); symptoms of disease (12 items); smoking behavior (1 item); medication use (17 items), physical function and health status (6 items); quantity and frequency of alcohol use (2 items); episodic heavy drinking (2 items); symptoms of alcohol abuse and dependence (4 items); driving after drinking (1 item), and gender (1 item). | 60 16 min | Developed for older adults; Complex scoring algorithm; Classifies as harmful, hazardous, or nonhazardous |
ASSIST | Instrument is a brief interview about alcohol, tobacco products, and other drugs; Alcoholic beverages (beer, wine, spirits, etc.) are a subset of each questionnaire item, which each lists a series of substances for potential abuse screening. Lifetime use (Response Choices: No=0; Yes=3) Use in past three months (Response Choices: Never=0; Once or Twice=2; Monthly=3; Weekly=4; Daily or Almost Daily=6) During the past three months, strong desire or urge to use (Response Choices: Never=0; Once or Twice=3; Monthly=4; Weekly=5; Daily or Almost Daily=6) During the past three months, how often use led to health, social, legal or financial problems (Response Choices: Never=0; Once or Twice=4; Monthly=5; Weekly=6; Daily or Almost Daily=7) During the past three months, how often failed to do what was normally expected because of use (Response Choices: Never=0; Once or Twice=5; Monthly=6; Weekly=7; Daily or Almost Daily=8) Friend or relative or anyone else expressed concern about use (Response choices: No, Never=0; Yes, in the past 3 months=6; Yes, but not in the past 3 months=3) Ever tried and failed to control, cut down or stop using (Response choices: No, Never=0; Yes, in the past 3 months=6; Yes, but not in the past 3 months=3) Ever used any drug by injection Response choices: No, Never=0; Yes, in the past 3 months=2; Yes, but not in the past 3 months=1) | 8 2-4 min | Add up the scores received for questions 2 through 7 inclusive. Does not include the results from either Q1 or Q8.. Score 0-10: no intervention; risk level low Score 11-26: receive brief Intervention; risk level moderate Score 27+ more intensive treatment; risk level high. Further assessment and more intensive treatment may be provided by the health professional(s) within primary care setting, or, by a specialist drug and alcohol treatment service when available. |
AUDIT |
| 10 2-5 min | Scoring: ≥8 considered a positive screen for hazardous or harmful drinking. In general: Scores between 8 and 15 are most appropriate for simple advice focused on the reduction of hazardous drinking; Scores between 16 and 19 suggest brief counseling and continued monitoring; Scores of 20 and above clearly warrant further diagnostic evaluation for alcohol dependence. |
AUDIT-C |
| 3 1-2 min | In men, ≥4 points is considered positive for alcohol misuse; in women, ≥3 points is considered positive. |
CAGE |
| 4 1 min | Score 1 point for each ‘yes’ response; range 0–4. Positive score ≥2. |
LAST |
| 7 1-2 mins | Score 1 point for answer of “no” on question 1; score 1 point for each ‘yes on questions 2-7.’ Two or more points are indicative of alcohol dependence or abuse |
MAST* | All items are yes/no questions
| 22 8-15 min | This quiz is scored by allocating 1 point to each ‘yes’ answer -- except for questions 1 and 4, where 1 point is allocated for each ‘no’ answer -- and totalling the responses. ≥5 is a positive screen for possible alcoholism |
MAST-G | All items are yes/no questions
| 24 10 min | This quiz is scored by allocating 1 point to each ‘yes’ answer ; ≥5 is a positive screen for possible alcoholism |
NET |
| 3 1 min | Score 1 point each for not normal or eye openers and 2 points for tolerance; range 0–4 |
shARPS | Includes items in the following: domains: presence of medical and psychiatric conditions (8 items); symptoms of disease (7 items); medication use (11 items), physical function and health status (1 item); quantity and frequency of alcohol use (2 items); episodic heavy drinking (1 item); symptoms of alcohol abuse and dependence (1 items); and driving after drinking (1 item) | 32 2-5 min | Developed for older adults; Complex scoring algorithm; Classifies as harmful/hazardous, or nonhazardous |
Single question: 12 months (NIAAA-recommended) | “How many times in the past year have you had X or more drinks in a day?” (X = 5 for men and 4 for women). | 1 1 min | ≥1 is a positive screen |
Single question: 3 months (often called SASQ) | “When was the last time you had more than X drinks in 1 day?,” where X was 4 for women and X was 5 for men Alternate wording: “On any single occasion during the past 3 months, have you had more than 5 drinks containing alcohol?” | 1 1 min | Positive if answer is within past 3 months. Positive if answer is yes. |
SMAST |
| 13 5 min | This quiz is scored by allocating 1 point to each ‘yes’ answer; ≥2 is a positive screen for possible alcoholism |
SMAST-G |
| 10 NR | This quiz is scored by allocating 1 point to each ‘yes’ answer; ≥2 is a positive screen for possible alcoholism |
T-ACE |
| 4 1 min | Score 2 points for tolerance; 1 point for others; range 0–5; threshold for positive score ≥2 |
TWEAK |
| 5 <2 min | Score 2 points each for first 2 items and 1 point each for last 3; range 0–7; positive score ≥2 |
- *
The original MAST included 25 questions and used a more complex scoring method; the version presented here represents the revised version used in practice today.
- ARPSFink A, Morton SC, Beck JC, et al. The Alcohol-Related Problems Survey: Identifying Hazardous and Harmful Drinking in Older Primary Care Patients. J Am Geriatr Soc. 2002;50:1717–1722. [PubMed: 12366628]
- ASSISTWHO ASSIST Working Group. The Alcohol Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction. 2002;97(9):1183–1194. [PubMed: 12199834]
Humeniuk RE, Ali RA, Babor TF, Farrell M, Formigoni ML, Jittiwutikarn J, de Larcerda R Boerngen, Ling W, Marsden J, Monteiro M, Nhiwhatiwa S, Pal H, Poznyak V, Simon S. Validation of the Alcohol Smoking and Substance Involvement Screening Test (ASSIST). Addiction. 2008;103(6):1039–1047. [PubMed: 18373724] - AUDITSaunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption – II. Addiction. 1993;88:791–804. [PubMed: 8329970]
- AUDIT-CBush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med. 1998 Sep 14;158(16):1789–95. [PubMed: 9738608]
- CAGEMayfield D, McLeod G, Hall P. The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry. 1974;131:1121–1123. [PubMed: 4416585]
Ewing JA. Detecting alcoholism: The CAGE questionnaire. JAMA. 1984;252(14):1905–1907. [PubMed: 6471323] - LASTRumpf H, Hapke U, Hill A, John U. Development of a screening questionnaire for the general hospital and general practices. Alcohol Clin Exp Res. 1997;21(5):894–898. [PubMed: 9267540]
- MASTSelzer ML. The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. American Journal of Psychiatry. 1971;127:1653–1658. [PubMed: 5565851]
- MAST-GBlow FC, Brower KJ, Schulenberg JE, Demo-Dananberg LM, Young JP, Beresford TP. The Michigan Alcoholism Screening Test – Geriatric Version (MAST-G): A new elderly-specific screening instrument. Alcoholism: Clinical and Experimental Research. 1992;16:372.
- NETBottoms S, Martier S, Sokol R. Refinements in screening for risk drinking in reproductive-aged women: the “NET” results. Alcohol Clin Exp res. 1989;13:339.
- NIAAANational Institute on Alcohol Abuse and Alcoholism. Helping Patients Who Drink Too Much: A Clinician's Guide. Washington, DC: U.S. Department of Health and Human Services; 2005.
- SMASTSelzer ML, Vinokur A, van Rooijen L. A self-administered Short Michigan Alcoholism Screening Test (SMAST). J Stud Alcohol. 1975;36(1):117–126. [PubMed: 238068]
- SMAST-GBlow FC, Gillespie BW, Barry KL, Mudd SA, Hill EM. Brief screening for alcohol problems in the elderly populations using the Short Michigan Alcoholism Screening Test-Geriatric Version (SMAST-G). Alcohol Clin Exp Res. 1998;22(Suppl):131A.
- T-ACESokol RJ, Martier SS, Ager JW. The T-ACE questions: practical prenatal detection of risk-drinking. Am J Obstet Gynecol. 1989;160:863–870. [PubMed: 2712118]
- TWEAKChan AWK, Pristach EA, Welte JW, Russell M. Use of the TWEAK test in screening for alcoholism/heavy drinking in three populations. Alcohol Clin Exp res. 1993;17:1188–1192. [PubMed: 8116829]
- SASQWilliams RH, Vinson DC. Validation of a single question screen for problem drinking. Journal of Family Practice. 2001;50:307–312. [PubMed: 11300981]
- shARPSMoore AA, Beck JC, Babor TF, Hays RD, Reuben DB. Beyond alcoholism: identifying older, at-risk drinkers in primary care. J Stud Alcohol. 2002;63:316–324. [PubMed: 12086132]
- Screening Instruments - Screening, Behavioral Counseling, and Referral in Primar...Screening Instruments - Screening, Behavioral Counseling, and Referral in Primary Care To Reduce Alcohol Misuse
- List of Excluded Studies - Screening, Behavioral Counseling, and Referral in Pri...List of Excluded Studies - Screening, Behavioral Counseling, and Referral in Primary Care To Reduce Alcohol Misuse
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