Psychometric properties of a single-item assessing drunkenness to identify hazardous drinking: a replication study

Background: The Alcohol Use Disorders Identification Test (AUDIT-C) is a commonly used scale to screen for hazardous alcohol use in various settings, including primary and emergency care settings. In such settings, brevity of effective screening tools is needed; therefore, single items have been developed and tested for detecting at-risk alcohol use behaviors. Purpose: This study replicates previous work validating the ability of a non-quantity-based single item assessing drunkenness to effectively identify signs of hazardous alcohol use. Methods: During fall 2013, alcohol use data were collected from 781 self-reported current drinkers. Concurrent validity of a drunkenness item to detect hazardous drinking behaviors was assessed against gender-based AUDIT-C thresholds. Convergent validity of the drunkenness item was assessed against biologic BrAC samples. Results: The single drunkenness item accounted for 0.856 of the area-under-the-received operating characteristics (ROC) curve for hazardous alcohol use (p < 0.001). Using a specific cut-off of 1, the drunkenness item was 99.8% sensitive in detecting hazardous drinking behavior and was 93.5% specific in identifying non-hazardous drinking behaviors. Conclusion: In a new sample, initial psychometric findings of the single drunkenness item to accurately detect hazardous alcohol use were replicated, providing additional support for the utility of this item.