-- Robert Preidt
TUESDAY, Jan. 15 (HealthDay News) -- Doctors fail to diagnose
most patients with alcohol problems when they rely solely on their
suspicions, rather than using proven screening methods, a new study
Researchers looked at almost 1,700 patients, and found that
about 14 percent screened positive for hazardous or harmful
Primary care doctors had suspected hazardous or harmful drinking
in just 5 percent of the patients, however. And of those patients,
less than two-thirds actually screened positive for a drinking
In other words, the primary care doctors failed to diagnose more
than 70 percent of patients with drinking problems when they relied
on their suspicions rather than using screening tools, the authors
According to the team, led by Dr. Daniel Vinson of the
University of Missouri, the findings support the routine use of
screening tools to supplement doctors' suspicions that a patient
may have a drinking problem.
Two experts not connected to the study had divergent views on
Bruce Goldman is director of Substance Abuse Services at the
Zucker Hillside Hospital in Glen Oaks, N.Y. He noted that,
"high-risk drinking is a major contributor to preventable health
and social problems," and primary care doctors "are uniquely
positioned to screen and assess all patients' patterns of alcohol
and drug use."
He agreed with the study authors that, "a few standardized
screening questions, consistently asked of all patients, could
quickly identify those who would benefit from either education or
referral to specialized care."
But another expert said that's easier said than done in
Dr. Neil Calman, chairman of family medicine and community
health at the Icahn School of Medicine at Mount Sinai, in New York
City, agreed that validated screening methods undoubtedly beat
doctors' suspicions in uncovering problem drinking in patients.
He added, however, that it's tougher to discern how well they
might be incorporated into physicians' everyday practice.
"First, most practices do not have the ability to deal with the conditions that are being detected," Calman noted. "Second, they identify many patients who do not choose to seek help for the detected issues and resources may be wasted on people who do not see the problem as something that needs to be addressed or that they want to have addressed."
Finally, Calman said, "we run the risk of keeping people out of
care for other critical conditions, as patients may report that
when they come in for an upper respiratory infection they do not
want or expect to be asked about other issues which they consider
highly personal and irrelevant to the reason for their visit."
As with many innovations in medicine, more research needs to be
done on how to best deploy these screening methods into everyday
clinical practice, Calman said.
The U.S. National Institute on Alcohol Abuse and Alcoholism has
alcohol use disorders.
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