Clinical Decision Support for Alcohol Screening and Brief Intervention

CDC funded the MITRE Corporation to develop standards-based clinical decision support (CDS) for alcohol screening and brief intervention. These CDS tools can assist with adoption of this important clinical preventive service in primary care settings. Users can integrate the tools into electronic health record (EHR) systems and other digital formats to inform decisions and improve healthcare delivery.

CDS tools for this project are based on the following:

• the U.S. Preventive Services Task Force guidance on screening and behavioral counseling interventions for unhealthy alcohol use,
• CDC’s alcohol SBI implementation guide [2 MB, 52 Pages, Print Only], and
• evidence related to specific screening instruments and brief intervention approaches.

The resources below are available to the public and posted on CDS Connect, a web-based platform for authoring and sharing CDS products. CDS Connect is maintained by the Agency for Healthcare Research and Quality (AHRQ). Select CDS resources are also available under open source license via GitHub.com, an online platform where software developers and coders can post and share code and software.

CDS resources include the following:

• Logic expressions and flow diagrams for five CDS tools
  • Three different screening instruments
    • AUDIT: Alcohol Use Disorders Identification Test (developed by the World Health Organization)
    • USAUDIT (adapted for the United States)
    • National Institute on Drug Abuse (NIDA) Quick Screen (for multiple substances)
  • Two brief intervention aids
    • Alcohol Brief Intervention and Referral
    • Patient Decision Aid on Alcohol Use
• Computer code and test files for each CDS
  • Coded logic expressed using clinical quality language and Fast Healthcare Interoperability Resources
  • Synthetic testing prior to integration into an EHR system
• Implementation guides for each CDS outlining
  • Description of selected instrument or evidence-based guidance
  • Clinical considerations for implementation
  • Key decisions on interpreting evidence-based guidance
  • Technical details and product testing processes
• Related apps and software available for several CDS on GitHub

A pilot project was conducted to test two of the CDS tools in a real-world setting. Access either the WHO Alcohol Use Disorders Identification Test CDS or the Alcohol Brief Intervention and Referral CDS for the Pilot Final Report describing this work.

Visit AHRQ’s CDS Connect website and Github.com to learn more.