Evidence map›Paper›PMID 40258803›Full record

ArticleAddiction (Abingdon, England)2025

Questionable generalizability of Alcohol Use Disorders Identification Test-Consumption scoring warrants caution when used for outcome monitoring: Evidence from simulated and real-world trial data.

Danilo Romero, Magnus Johansson, Anne H Berman, Philip Lindner

Abstract read
In one paragraph

Article in Addiction (Abingdon, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Danilo RomeroCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-4853-4947
Magnus JohanssonCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-8583-2620
Anne H BermanCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-7709-0230
Philip LindnerCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-3061-501X

Funding

Swedish Research Council for Health, Working Life, and Welfare 2019-01642
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe "Alcohol Use Disorders Identification Test - Consumption" (AUDIT-C), designed for primary-care screening, is frequently repurposed for outcome monitoring in brief intervention trials targeting problematic alcohol use. This repurposing may distort the instrument's internal structure and introduce right censoring, potentially undermining its ability to meaningfully capture problematic use and change thereof. The aim of the current study was to examine these concerns.

designPsychometric study. SETTING AND

participantsData from three sources were used: (1) individual-participant data from an internet-based brief intervention trial (n = 1169); (2) aggregated data from k = 15 additional brief intervention trials; and (3) k = 20 000 simulated cohorts generated using statistics from general-population samples. MEASUREMENTS: Internal structure of the AUDIT-C was examined through cross-item correlations, item step response functions (ISRF), and more. Responsiveness was assessed using interaction analysis, with changes in alcohol standard units (SU

findingsIn contrast to general-population cohorts, most brief intervention trials (68.8%) exhibited non-positive associations between frequency and quantity items. Congruently, ISRFs revealed non-monotonic patterns, disrupting ordinal measurement. Simulations suggested that negative frequency-quantity correlations appear at cut-offs of four (r = -0.04, 95% confidence interval [CI]: -0.019 - -0.068) or three (r = -0.13, 95% CI: -0.101 - -0.149). A one-unit AUDIT-C

conclusionsWhen used with typical brief intervention samples, using the AUDIT-C for outcome monitoring risks right-censoring (and thereby false negatives) and non-meaningful total scores. Researchers and clinicians should reconsider repurposing the AUDIT-C as an outcome measure in future alcohol intervention studies and re-examine prior trials that relied on it, to improve the quality of evidence.

Indexed as

AlcoholismAlcohol-Related DisordersOutcome Assessment, Health CareAdultFemaleHumansMaleMiddle AgedPrimary Health CarePsychometricsReproducibility of Resultsalcohol use disorders identification testAUDIT‐Cbrief interventionscollider biasproblematic alcohol usepsychometricsresponsivenessright censoringselection bias

Identifiers

PMID40258803
PMCPMC12319651

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.