Consistency between Self-Reported Alcohol Consumption and Biological Markers among Patients with Alcohol Use Disorder – A Systematic Review

ABSTRACT

Background

No systematic review has yet examined the consistency between self-reports of alcohol consumption and alcohol biomarkers among patients in treatment for alcohol use disorders (AUD). Therefore, we aimed to provide an overview of the consistency between self-reported alcohol intake and biomarkers among patients in treatment for AUD.

Methods

The electronical databases MEDLINE, PsycINFO, EMBASE, Cochrane Database of Systematic Reviews (CDSR) and CENTRAL were searched for all original studies that examined the validity of self-reported alcohol consumption using a biological marker in samples of patients with AUD. Eligible studies were included in a qualitative synthesis of the outcomes. Quality assessment was conducted with the quality assessment tool for Observational Cohort and Cross-sectional studies, developed by The National Heart, Lung and Blood Institute.

Results

The search identified 7672 hits, and 11 papers comprising 13 eligible studies were included. All the identified studies revealed inconsistencies between self-reporting and biomarkers. Under-reporting was the most common type of inconsistency across short-, intermediate- and long-term biomarkers. For short-term markers, under-reporting was indicated in 7 studies (n = 15 – 585) in a range from 5.5% to 56.0% of the patients, and over-reporting in 2 studies (n = 34- 65) in a range from 5.9% to 74.1%. Only under-reporting was reported for intermediate-term, direct markers and was indicated in 2 studies (n = 18 – 54) in a range from 5.0% and 50.0% of the patients. Although the results for long-term biomarkers were not reported consistently across the studies, under-reporting was indicated in 3 studies (n = 73 - 1580) in a range from 0.1% to 40.0% of the patients, and over-reporting in 2 studies (n = 15 – 1580) in a range from 13.0% to 70.6%. Correlations between self-reported alcohol consumption and biological markers were strongest for the intermediate-term direct markers, ranging from moderate to strong. For short-term and long-term markers, the correlations were mostly weak. Most of the studies were quality rated as fair.

Conclusion

The findings indicate that inconsistency between self-reported alcohol consumption and biomarkers may occur in a considerable proportion of patients with AUD. However, further studies applying more sensitive, specific, and easily assessable biological markers are warranted to confirm this preliminary synthesis.

PROSPERO registration no.: CRD42018105308