Finding time to screen for alcohol problems in a busy clinical setting is challenging and this has been the primary reason for developing and including a single item screening test in SIPS.

We developed this screening tool from the original Single Alcohol Screening Question (SASQ) (Williams & Vinson, 2001; Canagasaby & Vinson, 2005) which asks “When was the last time you had more than X drinks in one day?” Where X = 4 for women and 5 for men, with any time in the past 3 months considered a positive screen (1 drink = 14g ethanol – USA definition).

This tool has been modified and adapted to the UK’s standard drinks (1 drink = 8g ethanol) and validated during our pilot research. The new question asks “How often do you have X or more standard drinks on one occasion?” where X = 6 for women and 8 for men, with monthly or more frequently considered a positive screen (M-SASQ).

We tested the M-SASQ during a pilot study within the wider SIPS programme and found that it showed a higher sensitivity and specificity than the original SASQ (Sensitivity 91.8; Specificity 70.8; AUC 0.929) when compared to the gold standard Alcohol Use Disorders Identification Test (AUDIT). This new question is identical to the first item of the FAST questionnaire, which was also found to identify >50% of hazardous and harmful drinkers (Hodgson et al., 2002). The original SASQ has also undergone validity testing in primary care settings and has shown a high level of sensitivity and specificity for alcohol use disorders, although lower than FAST (Williams & Vinson, 2001; Canagasaby & Vinson, 2005). However, it is still unclear which of the two tools is most effective in identifying cases of hazardous and harmful drinking in routine primary care as well as other settings.
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