Increased cut-point of the TACER-3 screen reduces false positives without losing sensitivity in predicting risk alcohol drinking in pregnancy.
Alcohol Clin Exp Res
; 38(5): 1401-8, 2014 May.
Article
en En
| MEDLINE
| ID: mdl-24655071
ABSTRACT
BACKGROUND:
Detection of in-pregnancy maternal risk alcohol drinking is an essential first step in preventing fetal alcohol spectrum disorders, and the widely used T-ACE screen was developed for that purpose. We recently reported that increasing the total T-ACE score cut-point from 2 to 3 doubled specificity of detecting risk drinking in pregnancy and identified 4-year-old children with neurobehavioral effects associated with prenatal alcohol exposure.METHODS:
In this study, the TACER-3 was further validated in another prospectively identified high-risk urban cohort. Women were categorized as follows (i) Not At-Risk Group (negative on T-ACE and TACER-3); (ii) At-Risk Group (positive on T-ACE and TACER-3); and (iii) Change Risk Group (positive on T-ACE but negative on TACER-3).RESULTS:
The TACER-3 total score cut-point of 3 yielded fewer "false positives" than the T-ACE cut-point of 2. Based on relative risk scores, women in the TACER-3-positive At-Risk Group were more likely to drink alcohol during pregnancy than women in the Change Risk Group. In contrast, women in the Not At-Risk Group were largely not different in their drinking from women in the Change Risk Group. The largest increases in relative risk of the At-Risk Group compared to the Change Risk Group were for the amount of drinking per day across pregnancy (RR = 11.4) and for the amount of drinking per drinking day at the first prenatal visit (RR = 12.7). For both of these measures, the relative risk of at-risk alcohol consumption in the At-Risk Group was over >10 times that of the Change Risk Group.CONCLUSIONS:
Thus, the TACER-3 was more effective at selectively identifying women drinking at fetal risk levels than the original T-ACE. The TACER-3 allows for more efficient use of healthcare provider time in directing targeted clinical interventions with pregnant women identified as drinking at fetal risk levels.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones del Embarazo
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Consumo de Bebidas Alcohólicas
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
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Screening_studies
Límite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Año:
2014
Tipo del documento:
Article