Identification of heavy drinkers by using the early detection of alcohol consumption score

BACKGROUND: The objective of this study was to evaluate the use of routine blood chemistry and hematology tests to detect heavy drinkers among ambulatory subjects. Heavy drinkers were defined as subjects who consumed an average of four or more standard drinks per day if male and an average of three or more standard drinks per day if female, for at least 1 month before sample collection (1 standard drink = 15 ml of absolute ethanol). METHODS: A routine blood chemistry panel and the demographic factors of age, sex, and ethnicity were evaluated by using linear discriminant function (LDF) analysis to classify subjects as heavy drinkers or light drinkers. The classification was validated by comparison with drinking patterns established by standardized questionnaire and interview. Subjects (n = 807) were males and females with known drinking patterns recruited from 25 centers that included detoxification and rehabilitation institutions, churches, and community groups in the Milwaukee and Boston areas. RESULTS: With LDF, 88% of the heavy drinkers and 92% of the light drinkers were correctly identified by the Early Detection of Alcohol Consumption test. The LDF performed the best when used to identify heavy drinking in ages 40 and above, a group that showed 84% (120 of 143) sensitivity at 97% (152 of 157) specificity. Performance in females showed 73% (76 of 104) sensitivity at 94% (129 of 137) specificity, rates higher than obtained with any single biochemical marker previously examined. Receiver operating characteristic plot analysis showed areas under the curve of 0.94 for females and 0.95 for males (p < 0.0001). CONCLUSIONS: The Early Detection of Alcohol Consumption score is a practical laboratory screen for detecting heavy drinking based on blood constituents ordered routinely in clinical settings.