Portuguese Validated Versions of the Alcohol Use Disorders Identification Test: A Systematic Review of Academic and Grey Literature.

Abstract

Issues: The Alcohol Use Disorders Identification Test (AUDIT) is one of the best screening instruments for at-risk drinkers. However, a fully validated Portuguese version is lacking. This study aimed to review validated versions of the AUDIT in Portuguese and their characteristics.

Approach: A systematic search was performed in Ovid MEDLINE, CINAHL, PsycINFO, ÍndexRMP, LILACS, AJOL and Scielo databases, along with grey literature searches. Two authors independently extracted data and assessed the studies' methodological quality, using the QUADAS-2 checklist.

Key findings: Seven studies were included in this review, six from Brazil and the other from Portugal, in a total of three versions of the AUDIT achieved through translation-back translation. Studies reported acceptable to good internal consistency (Cronbach α = 0.72-0.86), moderate to excellent inter-rater reliability (K = 0.75-0.99), and poor to moderate test-retest reliability (K = 0.52-0.75). Sensitivity ranged from 52.2% to 100% and specificity from 64% to 98.9%. Only two studies reported on AUC, with values between 0.805 and 0.858. No study reported on all the performance characteristics and psychometric properties. The Portuguese translations for terms lacking a direct translation from English were heterogeneous.

Implications: This review could not identify any studies rigorously validating the AUDIT in Portuguese, raising concerns regarding the AUDIT's validity as a screening tool in Portugal and other Portuguese-speaking countries. The significant variation between versions raises questions regarding its efficacy.

Conclusion: The results of this review show the need for a validation study of the AUDIT in Portugal and other Portuguese-speaking countries and the development of a new version for Portugal.