Physicians' low detection rates of alcohol dependence or abuse: a matter of methodological shortcomings?

Gen Hosp Psychiatry. May-Jun 2001;23(3):133-7. doi: 10.1016/s0163-8343(01)00134-7.

Abstract

Previous research may have underestimated physicians' detection rates of alcohol dependence or abuse because case findings have been based on screening questionnaires instead of using in-depth diagnostic criteria and detection rates have been assessed by analyzing patient records instead of directly interviewing the physician. To test this hypothesis, consecutive patients of a general hospital (N=436) and of 12 randomly selected general practices (N=929) were examined. A two-step diagnostic procedure included screening questionnaires and a diagnostic interview (SCAN). The analysis compares detection rates based on methods used in previous studies to data using more precise methods. Physicians' detection rates ranged from 37.0% to 88.9% in the general hospital and from 11.1% to 74.7% in general practices depending on methods used. The physicians' detection rates could be improved by 10% (general hospital) and 20% (general practice) through the additional use of a screening questionnaire. Of those patients assessed by the physicians as problem drinkers in the general hospital, 13.9% were referred to an addiction consultation-liaison service. Data reveal that physicians' abilities to detect problem drinkers have been underestimated. Routine screening procedures could play a major role in improving detection rates and reminding the physician to intervene.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Attitude of Health Personnel
  • Bias
  • Family Practice
  • Female
  • Germany
  • Hospitals, General
  • Humans
  • Interviews as Topic / methods*
  • Interviews as Topic / standards
  • Male
  • Mass Screening / methods*
  • Mass Screening / standards
  • Medical Audit
  • Medical History Taking / methods*
  • Medical History Taking / standards
  • Middle Aged
  • Physicians / psychology
  • Referral and Consultation / statistics & numerical data
  • Sensitivity and Specificity
  • Substance-Related Disorders / diagnosis*
  • Surveys and Questionnaires / standards*