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Predicting the onset of hazardous alcohol drinking in primary care: development and validation of a simple risk algorithm

Angel Bellon, J; de Dios Luna, J; King, M; Nazareth, I; Motrico, E; Josefa GildeGomez-Barragan, M; Torres-Gonzalez, F; ... Moreno-Peral, P; + view all (2017) Predicting the onset of hazardous alcohol drinking in primary care: development and validation of a simple risk algorithm. British Journal of General Practice , 67 (657) E280-E292. 10.3399/bjgp17X690245. Green open access

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Abstract

Background Little is known about the risk of progressing to hazardous alcohol use in abstinent or low-risk drinkers. Aim To develop and validate a simple brief risk algorithm for the onset of hazardous alcohol drinking (HAD) over 12 months for use in primary care. Design and setting Prospective cohort study in 32 health centres from six Spanish provinces, with evaluations at baseline, 6 months, and 12 months. Method Forty-one risk factors were measured and multilevel logistic regression and inverse probability weighting were used to build the risk algorithm. The outcome was new occurrence of HAD during the study, as measured by the AUDIT. Results From the lists of 174 GPs, 3954 adult abstinent or low-risk drinkers were recruited. The ‘predictAL-10’ risk algorithm included just nine variables (10 questions): province, sex, age, cigarette consumption, perception of financial strain, having ever received treatment for an alcohol problem, childhood sexual abuse, AUDIT-C, and interaction AUDIT-C*Age. The c-index was 0.886 (95% CI = 0.854 to 0.918). The optimal cutoff had a sensitivity of 0.83 and specificity of 0.80. Excluding childhood sexual abuse from the model (the ‘predictAL-9’), the c-index was 0.880 (95% CI = 0.847 to 0.913), sensitivity 0.79, and specificity 0.81. There was no statistically significant difference between the c-indexes of predictAL-10 and predictAL-9. Conclusion The predictAL-10/9 is a simple and internally valid risk algorithm to predict the onset of hazardous alcohol drinking over 12 months in primary care attendees; it is a brief tool that is potentially useful for primary prevention of hazardous alcohol drinking.

Type: Article
Title: Predicting the onset of hazardous alcohol drinking in primary care: development and validation of a simple risk algorithm
Open access status: An open access version is available from UCL Discovery
DOI: 10.3399/bjgp17X690245
Publisher version: http://doi.org/10.3399/bjgp17X690245
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Primary Health Care, Medicine, General & Internal, General & Internal Medicine, Alcohol Consumption, Clinical Prediction Rule, Primary Health Care, Disorders Identification Test, Cluster Randomized-trial, Heavy Episodic Drinking, Primary-health-care, Major Depression, Mental-disorders, Young-adults, Childhood Maltreatment, European Countries, Family-history
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1549522
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