Alcohol problems among physicians are overestimated in some studies as researchers do not differentiate positive screens from prevalence rates, a Dublin conference on doctors’ health heard recently.



A more accurate estimation could be achieved by “using appropriate cut-offs on the one hand, and correcting for bias of the screening measures” such as the Alcohol Use Disorders Identification Test (AUDIT) by considering sensitivity and specificity, according to Prof Friedrich Wurst, Professor of Psychiatry and Psychotherapy and Chairman at the Paracelsus Medical University in Austria.

Describing research he was engaged in to improve estimates of prevalence rates of alcohol problems among physicians, Prof Wurst said the bias related to the limited accuracy of a screening test. An instrument such as the AUDIT, which was developed by the WHO as a screening tool for problematic drinking and alcohol use disorders, does not actually make a diagnosis, he explained.

Prof Wurst, who was speaking to IMT after his address at the recent conference of the European Association for Physician Health in Dublin, said that some research, “even in pretty prestigious journals”, continued to mix up positive screens with prevalence rates.

“There have been enormous, high rates of positive screens reported in physicians and some [studies], as I have mentioned before, mix it up and say ‘these are alcoholics’, which is not true,” he said.

Following the establishment of positive screens through AUDIT, the application of a correction formula considering specificity and sensitivity was necessary for an estimation of real prevalence, he added. Following this process, it was found that alcohol problems among physicians had prevalence rates comparable with the general population.