Validation of a single screening question for problem drinking

J Fam Pract. 2001 Apr;50(4):307-12.


Objective: The researchers hoped to confirm the sensitivity and specificity of a single screening question for problem drinking: "When was the last time you had more than X drinks in 1 day?", where X=4 for women and X=5 for men.

Study design: Cross-sectional study.

Population: Adult patients presenting to 3 emergency departments in Boone County, Missouri, for care within 48 hours of an injury.

Outcomes measured: The answers to the question were coded as never, more than 12 months ago, 3 to 12 months ago, and within the past 3 months. Problematic drinking was defined as either hazardous drinking (identified by a 29-day retrospective interview) or a past-year alcohol use disorder (defined by questions from the Diagnostic Interview Schedule).

Results: There was a 70% participation rate. Of 2517 interviewed patients: 29% were hazardous drinkers; 20% had a past-year alcohol use disorder; and 35% had either or both. Considering "within the last 3 months" as positive, the sensitivity of the single question was 86%, and the specificity was 86%. In men (n=1432), sensitivity and specificity were 88% and 81%; in women, 83% and 91%. Using the 4 answer options for the question, the area under the receiver-operating characteristic curve was 0.90. Controlling for age, sex, tobacco use, injury severity, and breath alcohol level in logistic regression models changed the findings minimally.

Conclusions: A single question about the last episode of heavy drinking has clinically useful sensitivity and specificity in detecting hazardous drinking and alcohol use disorders.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Alcoholism / diagnosis*
  • Cross-Sectional Studies
  • Emergency Service, Hospital
  • Female
  • Humans
  • Likelihood Functions
  • Male
  • Mass Screening*
  • Middle Aged
  • ROC Curve
  • Reproducibility of Results
  • Sensitivity and Specificity