Why do patients who have only one drink a day screen positive on the AUDIT-C?
The screening thresholds that balance sensitivity and specificity are based on studies that used in-depth interviews to assess patients’ drinking and problems due to drinking. These studies found that scores of 4 or more for men and 3 or more for women were optimal for identifying those with risky drinking or active alcohol use disorders, probably because patients often under-report their drinking.7, 16 However, like all screening tests, the AUDIT-C will have some false positives and some false negatives. Patients with positive AUDIT-C screens at scores of 3 for women or 4 for men might benefit from further assessment and/or intervention. This can be addressed in several ways, such as: • Review alcohol intake over the past few months to confirm accuracy, including details of intake for each day in the past week to determine whether typical drinking is within recommended limits. Ask the patient: Has this been your consistent pattern over the past 2-3 months? • Assess size of drinks and
