Why does the VA only require follow-up counseling for patients with AUDIT-C scores > 5, when AUDIT-C scores of > 4 for men (> 3 for women) are positive screens?
In some settings the burden or cost of counseling patients with false positive screens, relative to the benefit screening and brief counseling, is high enough that health care systems may choose to use a higher cut point. Therefore, the VA has elected to require follow up for its performance measure for brief alcohol counseling at the threshold of 5 to minimize the burden of false positives screens on providers. This also helps focus providers’ attention on the patients with more severe alcohol misuse.6, 16 The sensitivity and specificity for identifying patients with alcohol misuse (risky drinking, alcohol abuse or dependence) with a score of 5 or more in comparison with other thresholds are shown below. Sensitivity: the ability of the test to identify correctly those who have the condition; a test with high sensitivity has few false negatives. Specificity: the ability of the test to identify correctly those who do not have the condition; a test with high specificity has few false pos
