The Alcohol Clinical Index in lower socioeconomic alcohol-dependent men

The Alcohol Clinical Index, consisting of a 17-item Clinical Signs checklist and a 13-item Medical History questionnaire, was designed to provide an economic screening instrument for alcoholism not subject to self-report biases. There has been little validation work with this instrument. We therefore administered the Alcohol Clinical Index to a group of 40 alcohol-dependent men undergoing treatment at a VA Medical Center and a group of 17 nonalcoholic men being treated at an outpatient medical clinic at the same facility. The Clinical Signs checklist had high sensitivity, but poor specificity. Overall accuracy was 70% for a threshold score from 1 to 5. The Medical History questionnaire had more moderate sensitivity, but 100% specificity for a cutoff score of 2 or more. At a cutoff of 2, it had an overall accuracy of 84%. The high specificity of the Medical History questionnaire suggests that it could be used to help discriminate between alcoholics and nonalcoholics. Further study of these measures and individual items within the measures is recommended with different groups of alcohol users and nonusers.