Screening for alcohol problems: comparison of the audit, RAPS4 and RAPS4-QF among African American and Hispanic patients in an inner city emergency department.

Objective: to compare brief screening instruments for alcohol use disorders, the RAPS4, RAPS4-QF, and AUDIT, against DSM-IV criteria for alcohol dependence and alcohol abuse among African Americans and Hispanics in a sample of inner city emergency department (ED) patients.

Method: a probability sample of 395 African American and Hispanic patients seeking care at King Drew Medical Center Emergency Department were interviewed regarding items related to the screening and diagnostic instruments, quantity and frequency of drinking and demographic characteristics.

Results: no difference was found between the RAPS4 and AUDIT for alcohol dependence. Sensitivity of the RAPS4-QF (the RAPS4 plus a quantity item and a frequency item) was significantly better than the AUDIT for African Americans and Hispanics, and for males, but not for females, although the RAPS4-QF identified all of those women positive for alcohol abuse criteria, compared to 93% identified by the AUDIT.

Conclusion: the data suggest the RAPS4 and the RAPS4-QF perform well for identifying alcohol dependence and alcohol abuse, respectively, among minority ED patients. Additional research is needed to evaluate the RAPS4-QF as a stand-alone instrument and to evaluate both instruments across gender and ethnic subgroups in other populations and in other cultural settings.