Alcoholism and excessive alcohol intake are often unrecognized in general medical practice and hospitals. Researchers have shown that the use of discriminant analysis (DA) of blood chemistries can classify with high accuracy alcoholics or heavy drinkers. However, more research is needed to validate and optimize the method before it can be used as a screening instrument in clinical settings. Therefore, this project will use a random-digit-dial telephone survey to recruit subjects (18-65 years old) representative of the Buffalo metropolitan area, and to oversample male and female heavy drinkers, as well as blacks so that equal numbers of whites and blacks will be studied. A questionnaire containing multiple screening elements will be used to obtain drinking histories from the subjects and to classify subjects as alcoholics, heavy drinkers, and light drinkers. Blood samples from the subjects will be analyzed for 30 clinical tests commonly ordered by physicians. The hypothesis is that DA of blood chemistry profiles can correctly identify heavy drinkers in the general populations. Factors such as age, sex, race, physical and mental illness, and vitamin deficiencies etc. will be tested whether they will influence classification rates. Linear and quadratic DA (with or without a rank transformation), regression analyses, as well as the classification and regression tree method will be used to analyze the data. Another hypothesis to be tested is that the use of questionnaire data to classify heavy drinkers or alcoholics is more reliable if it is done in a research setting than if the data are gathered under clinical conditions. Therefore, patients visiting a local Primary Health Care Clinic will be included in the study. These subjects will also serve as medical controls for subjects in the general population study. Alcoholics in a treatment center will also be studied. Another hypothesis is that the sensitivity and specificity of the blood-chemistry-profiles method can be improved if extra biochemical tests are added in the DA. These tests are urinary ethanol, serum transferrin and the ratio of mitochondrial aspartate aminotransferase (AspAT) to total AspAT. Classification functions developed from these studies will be used to develop easy-to-use computer programs which will be applied to detect heavy drinkers or alcoholics in clinical patients. The successful application of these programs will improve the diagnosis of alcoholism in medical settings.
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| Chan, A W; Pristach, E A; Welte, J W et al. (1993) Use of the TWEAK test in screening for alcoholism/heavy drinking in three populations. Alcohol Clin Exp Res 17:1188-92 |
