Accuracy of Wearable Transdermal Alcohol Sensors: Systematic Review

Brobbin, Eileen; Deluca, Paolo; Hemrage, Sofia; Drummond, Colin

doi:10.2196/35178

Cited by 19 publications

(10 citation statements)

References 56 publications

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“…So far, CBIs have varied in their incorporation of evidence-based theory, which limits ability to identify effective components of interventions [ 56 ]. Finally, as the accuracy of transdermal alcohol sensors develops, CBIs can be paired via mobile phone to provide needed on-demand delivery of alcohol treatment [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Acceptability, Adaptability, and Feasibility of a Novel Computer-Based Virtual Counselor–Delivered Alcohol Intervention: Focus Group and In-depth Interview Study Among Adults With HIV or Tuberculosis in Indian Clinical Settings

Suryavanshi¹,

Dhumal²,

Cox³

et al. 2022

JMIR Form Res

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Background Unhealthy alcohol use is associated with increased morbidity and mortality among persons with HIV and tuberculosis (TB). Computer-based interventions (CBIs) can reduce unhealthy alcohol use, are scalable, and may improve outcomes among patients with HIV or TB. Objective We assessed the acceptability, adaptability, and feasibility of a novel CBI for alcohol reduction in HIV and TB clinical settings in Pune, India. Methods We conducted 10 in-depth interviews with persons with alcohol use disorder (AUD): TB (6/10), HIV (2/10), or HIV-TB co-infected (1/10) selected using convenience sampling method, no HIV or TB disease (1/10), 1 focus group with members of Alcoholics Anonymous (AA; n=12), and 2 focus groups with health care providers (HCPs) from a tertiary care hospital (n=22). All participants reviewed and provided feedback on a CBI for AUD delivered by a 3D virtual counselor. Qualitative data were analyzed using structured framework analysis. Results The majority (9/10) of in-depth interview respondents were male, with median age 42 (IQR 38-45) years. AA focus group participants were all male (12/12), and HCP focus group participants were predominantly female (n=15). Feedback was organized into 3 domains: (1) virtual counselor acceptability, (2) intervention adaptability, and (3) feasibility of the CBI intervention in clinic settings. Overall, in-depth interview participants found the virtual counselor to be acceptable and felt comfortable honestly answering alcohol-related questions. All focus group participants preferred a human virtual counselor to an animal virtual counselor so as to potentially increase CBI engagement. Additionally, interaction with a live human counselor would further enhance the program’s effectiveness by providing more flexible interaction. HCP focus group participants noted the importance of adding information on the effects of alcohol on HIV and TB outcomes because patients were not viewed as appreciating these linkages. For local adaptation, more information on types of alcoholic drinks, additional drinking triggers, motivators, and activities to substitute for drinking alcohol were suggested by all focus group participants. Intervention duration (about 20 minutes) and pace were deemed appropriate. HCPs reported that the CBI provides systematic, standardized counseling. All focus group and in-depth interview participants reported that the CBI could be implemented in Indian clinical settings with assistance from HIV or TB program staff. Conclusions With cultural tailoring to patients with HIV and TB in Indian clinical care settings, a virtual counselor–delivered alcohol intervention is acceptable and appears feasible to implement, particularly if coupled with person-delivered counseling.

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Section: Discussionmentioning

confidence: 99%

Acceptability, Adaptability, and Feasibility of a Novel Computer-Based Virtual Counselor–Delivered Alcohol Intervention: Focus Group and In-depth Interview Study Among Adults With HIV or Tuberculosis in Indian Clinical Settings

Suryavanshi¹,

Dhumal²,

Cox³

et al. 2022

JMIR Form Res

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“…The SCRAM samples the air on the skin every 30 minutes. A systematic review of 19 studies that evaluated the use of SCRAM in clinical and nonclinical settings found moderate to high correlations between the transdermal alcohol measurement and self-report ( r = 0.68-0.95) and estimated blood or breath alcohol concentrations (BrAC; r = 0.56-0.99), low malfunction rates (2%), 98.6% sensitivity, and 95.0% specificity for detecting 1 or more standard drink …”

Section: Methodsmentioning

confidence: 99%

“…We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and 95% CIs for this cutoff. We chose the SCRAM measure as the primary comparator because it is a purely objective measure of alcohol use with high correlation with alcohol consumption . We conducted similar analyses using self-reported heavy alcohol use as measured by event monitor presses and by AUDIT-C, as defined previously, to determine the robustness of the findings to other metrics of alcohol use.…”

Section: Methodsmentioning

confidence: 99%

Phosphatidylethanol vs Transdermal Alcohol Monitoring for Detecting Alcohol Consumption Among Adults

Hahn,

Fatch,

Barnett

et al. 2023

JAMA Netw Open

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ImportanceAlcohol biomarkers can improve detection of heavy alcohol use in clinical care, yet cutoffs for phosphatidylethanol (PEth), a blood biomarker, have not been established.ObjectiveTo determine the optimal cutoff for PEth for heavy alcohol consumption in a study of middle-age and older adults.Design, Setting, and ParticipantsThis was a 4-week diagnostic study of adults with paroxysmal atrial fibrillation (AF) and current alcohol consumption, recruited from general cardiology and cardiac electrophysiology outpatient clinics from September 2014 to September 2019. Data were analyzed from October 2021 to March 2022.Main Outcomes and MeasuresThe main aim was to determine the optimal PEth cutoff for heavy alcohol consumption, using the Secure Continuous Remote Alcohol Monitor (SCRAM) to measure transdermal alcohol. Area under the curve (AUC) for PEth-detected compared with SCRAM-detected heavy alcohol consumption in any week over the prior 4 weeks (ie, ≥3 [women] and ≥4 [men] episodes) or any estimated breath alcohol of 0.08% or greater in any week, and the PEth cutoff was calculated using the Youden J statistic. Similar analyses were conducted comparing PEth with individual drinks reported by pressing an event monitor, retrospective self-report via the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C), and using 2-week look-backs.ResultsIn this diagnostic study of 64 patients with both PEth and SCRAM measures over 4 weeks (54 [84.4%] men; mean age, 65.5 [95% CI, 62.6-68.5] years; 51 [79.7%] White), 31 (48.4%) had any SCRAM-detected heavy alcohol consumption over the 4 weeks, and the median (IQR) PEth at 4 weeks was 23 ng/mL (&lt;limit of quantification to 60 ng/mL). The AUC for PEth vs any SCRAM-detected heavy alcohol consumption was 0.83 (95% CI, 0.72-0.93). The optimal PEth cutoff was 18.5 ng/mL (AUC, 0.83; 95% CI, 0.72-0.93), with sensitivity of 83.9% (95% CI, 66.3%-94.5%) and specificity of 72.7% (95% CI, 54.5%-86.7%). The PEth test characteristics by individual drink reporting using the event monitors and by the AUDIT-C, and by these measures and by SCRAM collected for 2-week intervals, were similar to those compared with the 4-week SCRAM.Conclusions and RelevanceIn a predominately middle-age and older White male population, PEth compared well with SCRAM. A PEth cutoff of 18.5 ng/mL (or rounded to 20 ng/mL, a recommended PEth cutoff for significant alcohol consumption) can be used in clinical care to detect heavy alcohol consumption in middle-age and older men.

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“…This protocol has been registered on the Prospective Register of Systematic Reviews (PROSPERO CRD42021231027). On review of the results, it was decided that the findings of this systematic review should be reported in 2 papers: this paper focusing on acceptability and feasibility outcomes and another paper on accuracy outcomes [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Acceptability and Feasibility of Wearable Transdermal Alcohol Sensors: Systematic Review

Brobbin¹,

Deluca²,

Hemrage³

et al. 2022

JMIR Hum Factors

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Background Transdermal alcohol sensors (TASs) have the potential to be used to monitor alcohol consumption objectively and continuously. These devices can provide real-time feedback to the user, researcher, or health professional and measure alcohol consumption and peaks of use, thereby addressing some of the limitations of the current methods, including breathalyzers and self-reports. Objective This systematic review aims to evaluate the acceptability and feasibility of the currently available TAS devices. Methods A systematic search was conducted in CINAHL, EMBASE, Google Scholar, MEDLINE, PsycINFO, PubMed, and Scopus bibliographic databases in February 2021. Two members of our study team independently screened studies for inclusion, extracted data, and assessed the risk of bias. The study’s methodological quality was appraised using the Mixed Methods Appraisal Tool. The primary outcome was TAS acceptability. The secondary outcome was feasibility. The data are presented as a narrative synthesis. Results We identified and analyzed 22 studies. Study designs included laboratory- and ambulatory-based studies, mixed designs, randomized controlled trials, and focus groups, and the length the device was worn ranged from days to weeks. Although views on TASs were generally positive with high compliance, some factors were indicated as potential barriers and there are suggestions to overcome these. Conclusions There is a lack of research investigating the acceptability and feasibility of TAS devices as a tool to monitor alcohol consumption in clinical and nonclinical populations. Although preliminary evidence suggests their potential in short-term laboratory-based studies with volunteers, more research is needed to establish long-term daily use with other populations, specifically, in the clinical and the criminal justice system. Trial Registration PROSPERO CRD42021231027; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=231027

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Accuracy of Wearable Transdermal Alcohol Sensors: Systematic Review

Cited by 19 publications

References 56 publications

Acceptability, Adaptability, and Feasibility of a Novel Computer-Based Virtual Counselor–Delivered Alcohol Intervention: Focus Group and In-depth Interview Study Among Adults With HIV or Tuberculosis in Indian Clinical Settings

Acceptability, Adaptability, and Feasibility of a Novel Computer-Based Virtual Counselor–Delivered Alcohol Intervention: Focus Group and In-depth Interview Study Among Adults With HIV or Tuberculosis in Indian Clinical Settings

Phosphatidylethanol vs Transdermal Alcohol Monitoring for Detecting Alcohol Consumption Among Adults

Acceptability and Feasibility of Wearable Transdermal Alcohol Sensors: Systematic Review

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