higher scores indicating greater likelihood of harmful drinking. The first three AUDIT items measure the quantity and frequency of alcohol consumption and comprise the AUDIT-C, whose scores range from 0–12, with higher scores indicating greater alcohol consumption.34 A meta-analysis of 14 studies directly compared the performance of the AUDIT and AUDIT-C in screening for AUD in primary care, with no significant difference in accuracy between them.35 For the AUDIT, the optimal cut-off score is ≥4 (which yields sensitivity and specificity for detecting heavy alcohol use of 84–85% and 77–84%, respectively) or ≥5 (sensitivity of 70–92% and specificity of 73–94%).32 At a cut-off score of ≥4, the AUDIT-C has a sensitivity of 74–76% and a specificity of 80–83%) and at ≥3 its sensitivity is 74–88% and specificity is 64–83%.31 For the single-item questionnaire, ≥1 binge drinking day in the past year had a sensitivity of 82–87% and a specificity of 61–79%.31 Although all three self-report screening approaches perform well in identifying binge drinking or heavy alcohol use, the single-item and 3-item AUDIT-C are briefer and more feasible for clinical use than the AUDIT.
