Abstract:
Background: Alcohol use disorder is a major health problem among medical outpatients and
remains undetected by clinicians. To identify alcohol use disorder in a busy clinical setting a
brief, rapid, and flexible screening tools are important. Alcohol Use Disorders Identification
Test (AUDIT) is most commonly used screening tool which is validated in outpatient setting. The
psychometric properties of AUDIT have not been validated for Ethiopian population.
Objective: To assess the reliability and validity of AUDIT screening tool among medical
outpatients at Dessie Referral Hospital, internal medicine outpatient clinic, 2018.
Methods: A cross-sectional study was conducted among 325 patients attending internal
medicine outpatient department. Psychometric properties of AUDIT were be analyzed against
the Mini International Neuropsychiatry Interview (MINI), as the gold standard, to detect AUD
based on DSM V. The reliability was determined by examining internal consistency. The receiver
operating characteristic curve was established to calculate sensitivity and specificity of the
screening tool. Construct Validity was determined using both exploratory and confirmatory
factor analysis.
Result: The translated version of AUDIT showed language clarity. Internal consistency was
excellent (cronbach’s alpha=0.9). AUDIT provide an excellent ROC with cutoff point ≥ 8 for
females (sensitivity: 0.92, specificity: 0.87, PPV: 70.2, NPV: 96.9, LR+: 7.16 and LR- of 0.) and
≥ 10 for males (sensitivity of 0.91, specificity of 0.84, PPV: 72.6%, NPV: 95.3%, LR+: 5.57 and
LR- of 0.10). Principal component analysis provided a 2- factor structure with 67.3% total
variance. Confirmatory factor analysis provided good model fit indices for two and three factor
model, with superiority of two factor model.
Conclusions and recommendations: The AUDIT has been shown to be a valid instrument for
screening AUDs in Amharic speaking medical outpatients.
