TY - JOUR
T1 - Psychometric Properties of the Revised Clinical Institute Withdrawal Alcohol Assessment and the Brief Alcohol Withdrawal Scale in a Psychiatric Population
AU - Elefante, Raymond Julius
AU - Batkis, Marcelo
AU - Nelliot, Archana
AU - Abernathy, Karen
AU - Rocha, Kristi
AU - Jenkins, Freddie
AU - Rastegar, Darius Anthony
AU - Neufeld, Karin Jane
N1 - Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2020/12/1
Y1 - 2020/12/1
N2 - OBJECTIVE: Psychiatric illness complicates the assessment of alcohol and sedative withdrawal (ASW). This study measured the diagnostic characteristics of the Revised Clinical Institute Withdrawal Alcohol Assessment (CIWA-Ar) and the Brief Alcohol Withdrawal Scale (BAWS) compared with a reference standard in patients with psychiatric illness and evaluated their administration time. METHODS: This prospective quality improvement (QI) project conducted in November, 2016 evaluated 35 consecutive unique patients in psychiatric settings. Each patient was evaluated on 1 occasion, sequentially by 2 independent examiners with the CIWA-Ar and BAWS. A Diagnostic Statistical Manual of Mental Disorders, Fifth Edition diagnosis of ASW derived after medical record review by 2 psychiatrists blind to the screening results served as a reference standard. Psychometric properties of the CIWA-Ar and BAWS were measured against the reference. RESULTS: Nineteen (54%) patients had ASW diagnosis by the reference standard. The sensitivity (95% confidence interval [CI]) of the CIWA-Ar was 47% (25%-71%) at a cut-off score ≥8; sensitivity of the BAWS was 79% (54%-94%) at a cut-off score ≥3. Specificity (95% CI) for CIWA-Ar and BAWS was 88% (62%-98%) and 88% (62%-98%), respectively. Administration times (interquartile range) for the CIWA-Ar and BAWS were 120 (60-180) and 65 (50-75) seconds, respectively. Receiver operator characteristic area under the curve for CIWA-Ar was 0.77 and for BAWS was 0.76 (P = 0.86). CONCLUSION: Both instruments performed similarly in assessing for mild to moderate ASW in a sample of patients with psychiatric illness. The BAWS took 65 seconds to administer-almost half as much time as the CIWA-Ar.
AB - OBJECTIVE: Psychiatric illness complicates the assessment of alcohol and sedative withdrawal (ASW). This study measured the diagnostic characteristics of the Revised Clinical Institute Withdrawal Alcohol Assessment (CIWA-Ar) and the Brief Alcohol Withdrawal Scale (BAWS) compared with a reference standard in patients with psychiatric illness and evaluated their administration time. METHODS: This prospective quality improvement (QI) project conducted in November, 2016 evaluated 35 consecutive unique patients in psychiatric settings. Each patient was evaluated on 1 occasion, sequentially by 2 independent examiners with the CIWA-Ar and BAWS. A Diagnostic Statistical Manual of Mental Disorders, Fifth Edition diagnosis of ASW derived after medical record review by 2 psychiatrists blind to the screening results served as a reference standard. Psychometric properties of the CIWA-Ar and BAWS were measured against the reference. RESULTS: Nineteen (54%) patients had ASW diagnosis by the reference standard. The sensitivity (95% confidence interval [CI]) of the CIWA-Ar was 47% (25%-71%) at a cut-off score ≥8; sensitivity of the BAWS was 79% (54%-94%) at a cut-off score ≥3. Specificity (95% CI) for CIWA-Ar and BAWS was 88% (62%-98%) and 88% (62%-98%), respectively. Administration times (interquartile range) for the CIWA-Ar and BAWS were 120 (60-180) and 65 (50-75) seconds, respectively. Receiver operator characteristic area under the curve for CIWA-Ar was 0.77 and for BAWS was 0.76 (P = 0.86). CONCLUSION: Both instruments performed similarly in assessing for mild to moderate ASW in a sample of patients with psychiatric illness. The BAWS took 65 seconds to administer-almost half as much time as the CIWA-Ar.
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U2 - 10.1097/ADM.0000000000000655
DO - 10.1097/ADM.0000000000000655
M3 - Article
C2 - 32209957
AN - SCOPUS:85089965256
SN - 1932-0620
VL - 14
SP - e355-e358
JO - Journal of addiction medicine
JF - Journal of addiction medicine
IS - 6
ER -