Week 2 Discussion

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Chamberlain University College of Nursing *

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NR503NP

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Health Science

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Apr 3, 2024

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Week 2 Discussion: Describe the diagnostic or screening tool selected, its purpose, and what age group it targets. Has it been specifically tested in this age group? Next, discuss the predictive ability of the test. For instance, how do you know the test is reliable and valid? What are the predictive values? Is it sensitive to measure what it has been developed to measure, for instance, HIV, or depression in older adults, or Lyme disease? Would you integrate this tool into your advanced practice based on the information you have read about the test, why or why not? The screening tool that I have identified is the Alcohol Use Disorders Identification Test (AUDIT). AUDIT is a tool utilized to identify alcohol use disorder, a pattern of excessive drinking that can cause serious problems at work, in relationships, and health (MedlinePlus, 2021). AUDIT has been used worldwide since 1989 and developed by the World Health Organization, and enquires about three main areas: alcohol intake, potential dependence on alcohol, and experience of alcohol-related harm (AUDIT, 2020). The screening tool contains 10 multiple choice questions about how much and how often an individual drinks alcohol and if there are any alcohol-related problems or reactions (MedlinePlus, 2021). AUDIT is targeted at adults age 18 and older. The website Auditscreen.org (2020) has links to several validation studies and research papers that disclose the development and validation of the AUDIT tool, guidelines for its use, its validation in different populations, AUDIT derivatives, and comparisons with other screening instruments. The predictive value of the AUDIT screening tool can be analyzed by reviewing the various studies and research papers to test the AUDIT tool. In a study by Gils et al. (2021), researchers studied the AUDIT tool in relation to use in older adults 65 years and older. The researchers found that 89% of men and 90% of women could be classified correctly in terms of hazardous alcohol use when utilizing the AUDIT tool (Gils et al., (2021). In a study by Villarosa-Hurlocker et al. (2020), researchers analyzed the AUDIT tool when used to identify at-risk college age students for harmful drinking. Researchers identified that the AUDIT tool was a valid screening tool, but also recommended that the consumption subscale of the AUDIT-US tool be utilized as the best predictor for at-risk college drinkers (Villarosa-Hurlocker et al., 2020). This study also reported that the sensitivity can be effected based off of the optimal cutoff score for the AUDIT tool, noticing that with a increase in cutoff score, there was a correlated decrease in sensitivity (Villarosa-Hurlocker et al., 2020). They also identified that in reducing the sensitivity by increasing the cutoff score, it would reduce the false positive rate and therefore could lead to an increase in false negative results; a false negative meaning individuals being incorrectly not diagnosed with an alcohol use disorder (Villarosa-Hurlocker et al., 2020). This can be almost more harmful than a false positive result, as it could result in these individuals not receiving further evaluation or interventions. Villarosa-Hurlocker et al. (2020) therefore recommends that healthcare providers utilizing the AUDIT tool should focus on higher cutoff scores to decrease the sensitivity potential.

The AUDIT tool could definitely be a screening mechanism that I would be interested in utilizing in my practice as an advanced practice nurse. The AUDIT tool questions help the individual reflect on the relationship between people and alcohol, helps identify the ability to cause dependence, and identify the harmful consequences that an individual could face. As a healthcare provider it is important to keep our patients well informed and provide resources for our patients for their health and wellbeing. Screening tools like the AUDIT tool help to provide prevention for further harm towards our patients that should be available when a need is identified. AUDIT. (2020). Alcohol Use Disorders Identification Test. https://auditscreen.org/ Gils, Y., Franck, E., Dierckx, E., van Alphen, S., Saunders, J., & Dom, G. (2021). Validation of the AUDIT and AUDIT-C for hazardous drinking in community-dwelling older adults. International Journal of Environmental Research and Public Health. https://www.mdpi.com/1660-4601/18/17/9266 MedlinePlus. (2021). Alcohol Use Screening Tests. National Library of Medicine. https://medlineplus.gov/lab-tests/alcohol-use-screening-tests/ Villarosa-Hurlocker, M., Schutts, J., Madson, M., Jordan, H., Whitley, R., & Mohn, R. (2020) Screening for alcohol use disorders in college student drinkers with the AUDIT and the USAUDT: a receiver operating characteristic curve analysis. The American Journal of Drug and Alcohol Abuse, 46(5). https://doi.org/10.1080/00952990.2020.1712410

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