DOVER and QUVER—New Marker Combinations to Detect and Monitor At‐risk Drinking

Berner, Michael; Bentele, Michael; Kriston, Levente; Mänz, Constantin; Härter, Martin; Mundle, Götz

doi:10.1111/j.1530-0277.2006.00163.x

Cited by 10 publications

(12 citation statements)

References 52 publications

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“…However, in a broad sense, the utility of these biomarkers as diagnostic tools is greatly hampered due to variable results in different populations and low sensitivity and specificity. For example, clinical studies of CDT have found a range of sensitivities (77–100%) and specificities (10–85%) (Berner et al, 2006;Koch et al, 2004;Miller et al, 2006). These limitations may arise from several factors.…”

Section: Current Biomarkers Of Alcoholismmentioning

confidence: 99%

Circulating Cytokines as Biomarkers of Alcohol Abuse and Alcoholism

Achur

Freeman

Vrana

2009

J Neuroimmune Pharmacol

168

122

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There are currently no consistent objective biochemical markers of alcohol abuse and alcoholism. Development of reliable diagnostic biomarkers that permit accurate assessment of alcohol intake and patterns of drinking is of prime importance to treatment and research fields. Diagnostic biomarker development in other diseases has demonstrated the utility of both open, systems biology, screening for biomarkers and more rational focused efforts on specific biomolecules or families of biomolecules. Long term alcohol consumption leads to altered inflammatory cell and adaptive immune responses with associated pathologies and increased incidence of infections. This has led researchers to focus attention on identifying cytokine biomarkers in models of alcohol abuse. Alcohol is known to alter cytokine levels in plasma and a variety of tissues including lung, liver, and very importantly brain. A number of cytokine biomarker candidates have been identified, including: TNF alpha, IL1-alpha, IL1-beta, IL6, IL8, IL12 and MCP-1. This is an emerging and potentially exciting avenue of research in that circulating cytokines may contribute to diagnostic biomarker panels and a combination of multiple biomarkers may significantly increase the sensitivity and specificity of the biochemical tests aiding reliable and accurate detection of excessive alcohol intake.

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Section: Current Biomarkers Of Alcoholismmentioning

confidence: 99%

Circulating Cytokines as Biomarkers of Alcohol Abuse and Alcoholism

Achur

Freeman

Vrana

2009

J Neuroimmune Pharmacol

168

122

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“…Selin (9), for example, concluded that an AUDIT questionnaire (containing all 10 items) reliably discriminates between four differently defined alcohol-related problems (excessive consumption, alcohol-related social problems, alcoholinduced health problems, and alcohol dependence). Berner et al (10) confirmed good AUDIT validity through the application of objective biological markers (CDT and GGT). They concluded that a screening questionnaire in combination with laboratory tests improve diagnostics in comparison to the separate use of any of the methods.…”

Section: Discussionmentioning

confidence: 92%

The Czech AUDIT: Internal Consistency, Latent Structure and Identification of Risky Alcohol Consumption

Sovinová¹,

Csémy²

2010

Cent Eur J Public Health

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SUMMARY Aim:The primary aim of the study is to examine the psychometric properties and the structure of the Czech version of the Alcohol Use Disorders Identification Test (AUDIT), and to estimate the rate of risky, harmful and problematic alcohol consumers.Methods and sample: Two large data sets were analyzed. The first was based on the application of the AUDIT as a part of a general population survey (N=1.326; age range 18-64), the second represents data gathered by general practitioners (GPs) in the context of a pilot screening and brief advice (SBA) project in the area of Greater Prague (N=2.589).Results: Analyses of reliability showed satisfying internal consistency of the AUDIT (Cronbach's =0.83 for population survey and 0.77 for survey based on SBA). Principal component analyses suggest two factor solutions where one factor represents drinking patterns and the second alcohol-related problems or symptoms of dependence. The principal component analyses of both data sets led to similar factor formation. A total of 19% of the general population sample was classified as risky or harmful drinkers and 2% as problem drinkers. These figures were slightly lower in the sample of patients of general practitioners.Conclusions: The Czech version of the AUDIT seems to be a plausible screening instrument. The properties of the instrument suggest usefulness of the summary score for identification of the level of risk.

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“…For AUDIT-C, we considered a score of ≥5 (out of a possible 12 points) positive for a man and ≥2 positive for a woman (Bradley et al, 2003, 2007; Gordon et al, 2001). The cut-off for %CDT was 2.6% as recommended by the manufacturers (Axis Shield ASA, Oslo, Norway; Berner et al, 2006). We assumed all screen-positive patients completed a full clinical assessment (i.e., the gold standard) for unhealthy alcohol use.…”

Section: Methodsmentioning

confidence: 99%

“…Heavy daily consumption of alcohol for 2 weeks or more triggers a positive test. Studies have found that %CDT has high specificity (77 to 100%) but variable sensitivity (10 to 85%) (Berner et al, 2006; Koch et al, 2004; Miller and Anton, 2004). Performance estimates vary depending on whether the goal of screening is to detect very heavy drinking (>60 to 80 g of ethanol or more than 5 to 7 drinks per day) or the at-risk amounts defined above.…”

mentioning

confidence: 99%

Cost‐Effectiveness of Screening for Unhealthy Alcohol Use with %Carbohydrate Deficient Transferrin: Results From a Literature‐Based Decision Analytic Computer Model

Kapoor

Kraemer

Roberts

et al. 2009

Alcoholism Clin & Exp Res

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Background The %carbohydrate deficient transferrin (%CDT) test offers objective evidence of unhealthy alcohol use but its cost-effectiveness in primary care conditions is unknown. Methods Using a decision tree and Markov model, we performed a literature-based cost-effectiveness analysis of 4 strategies for detecting unhealthy alcohol use in adult primary care patients: (i) Questionnaire Only, using a validated 3-item alcohol questionnaire; (ii) %CDT Only; (iii) Questionnaire followed by %CDT (Questionnaire-%CDT) if the questionnaire is negative; and (iv) No Screening. For those patients screening positive, clinicians performed more detailed assessment to characterize unhealthy use and determine therapy. We estimated costs using Medicare reimbursement and the Medical Expenditure Panel Survey. We determined sensitivity, specificity, prevalence of disease, and mortality from the medical literature. In the base case, we calculated the incremental cost-effectiveness ratio (ICER) in 2006 dollars per quality-adjusted life year ($/QALY) for a 50-year-old cohort. Results In the base case, the ICER for the Questionnaire-%CDT strategy was $15,500/QALY compared with the Questionnaire Only strategy. Other strategies were dominated. When the prevalence of unhealthy alcohol use exceeded 15% and screening age was <60 years, the Questionnaire-%CDT strategy costs less than $50,000/QALY compared to the Questionnaire Only strategy. Conclusions Adding %CDT to questionnaire-based screening for unhealthy alcohol use was cost-effective in our literature-based decision analytic model set in typical primary care conditions. Screening with %CDT should be considered for adults up to the age of 60 when the prevalence of unhealthy alcohol use is 15% or more and screening questionnaires are negative.

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DOVER and QUVER—New Marker Combinations to Detect and Monitor At‐risk Drinking

Cited by 10 publications

References 52 publications

Circulating Cytokines as Biomarkers of Alcohol Abuse and Alcoholism

Circulating Cytokines as Biomarkers of Alcohol Abuse and Alcoholism

The Czech AUDIT: Internal Consistency, Latent Structure and Identification of Risky Alcohol Consumption

Cost‐Effectiveness of Screening for Unhealthy Alcohol Use with %Carbohydrate Deficient Transferrin: Results From a Literature‐Based Decision Analytic Computer Model

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