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Patients with Alcohol Problems
- David A. Fiellin, MD;
- M. Carrington Reid, PhD, MD; and
- Patrick G. O'Connor, MD, MPH
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE:
Drs. Milionis and Elisaf acknowledge the importance of formal screening instruments in helping primary care clinicians identify patients with latent alcohol problems. We agree that selected laboratory tests can provide clues to the presence of unsuspected alcohol problems without having the appropriate operating characteristics to make useful screening tools (1, 2). Drs. Milionis and Elisaf point out that patients with alcohol problems may have electrolyte disorders and cite studies conducted among patients admitted for causes related to alcohol abuse (3, 4). We appreciate their description of this unique cohort of patients and agree that these clues to excessive alcohol consumption may often be overlooked in routine clinical practice.
In our recent systematic review of this literature, no studies focused on the operating characteristics of electrolyte disturbances in primary care. Therefore, their sensitivity and specificity in this clinical setting are unknown (2). Additional studies may be warranted to determine the operating characteristics of these laboratory analyses in primary care. Given the prevalence of alcohol disorders in primary care, the demonstrated value of formal screening instruments in identifying patients with latent alcohol problems in this setting, and the benefits of early treatment, we recommend that busy clinicians use such screening methods as the CAGE questionnaire and AUDIT, both of which are efficient and effective in identifying patients with alcohol problems.
David A. Fiellin, MD
M. Carrington Reid, PhD, MD
Patrick G. O'Connor, MD, MPH
Yale University School of Medicine
New Haven, CT 06520-8025
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
