The Diagnostic Validity of Screening Tests and Laboratory Markers in Alcohol Use Disorders
Dr. Selami GÜL, Dr. Yıldız AKVARDAR, Dr. Gültekin TAŞ, Dr. Pınar TUNCEL
2005; 16(1): 3-12

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Objective: To determine the validity of screening tests and markers suggested in the early detection of alcohol use disorders.

Method: Male patients aged 20-65 were recruited from a psychiatry clinic. They had been consuming alcohol at least once a week. They were not drug users and had no other diseases that affected the markers mentioned in this study. According to the DSM-IV diagnostic criteria, the diagnostic validity of screening tests [Michigan Alcoholism Screening Test (MAST), CAGE (Cut down, Annoyed, Guilty, Eye-opener), Alcohol Use Disorders Identification Test  (AUDIT)] and markers [Mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT)] was investigated in alcohol dependent patients (n=29), alcohol abusers (n=28) and social drinkers (n=28).

Results: For the diagnosis of dependence, the sensitivity and specificity of the tests were respectively 69% and 100% for GGT, 41% and 93% for CDT, 100% and 57% for MAST, 97% and 86% for CAGE, and 100% and 75% for AUDIT. For the diagnosis of abuse, the sensitivity and specificity of the tests were respectively 32% and 100% for GGT, 32% and 93% for CDT, 86% and 57% for MAST, 75% and 85.7% for CAGE, and 89% and 75% for AUDIT. The widest area under the ROC curve  belonged to GGT as a marker and AUDIT as a screening test.

Conclusion: According to the results of this study, the marker that has the highest validity is GGT, while AUDIT and CAGE are the best screening tests.

Keywords:  Alcohol use disorders, screening tests, markers, validity