***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To describe the epidemiology of cases of fetal alcohol syndrome ( FAS ) seen by Australian paediatricians . Methods : Active , national case-finding using the Australian Paediatric Surveillance Unit ( APSU ) . Monthly reporting of incident cases aged < 15 years by paediatricians between January 2001 and December 2004 . Results : Over 1150 paediatricians su bmi tted reports each month to the APSU . Of 169 reported cases , 92 fulfilled the study criteria for FAS . There was a significant increase in the number of children reported each year from 2001 to 2004 . Of 92 children , 53.3 % were male , 35.7 % were preterm ( < 37 weeks ’ gestation ) and 64.6 % were of low birth weight ( < 2.5 kg ) . Most ( 94.4 % ) had high risk exposure to alcohol in utero and 78.3 % were exposed to one or more additional drugs . The median age at diagnosis was 3.3 years ( range : newborn to 11.9 years ) : 6.5 % were diagnosed at birth and 63 % by 5 years of age . Of the 92 cases , 56 % had growth deficiency , 53.2 % had microcephaly , 85.9 % had evidence of central nervous system dysfunction , 24 % had additional birth defects , 5.4 % had sensorineural deafness and 4.3 % had visual impairment .  Of children with FAS , 65 % were Indigenous , 51 % had a sibling with FAS , and only 40.2 % lived with a biological parent . Conclusion : Our data are the only prospect i ve national data available on FAS throughout the world . These findings highlight the severity , complexity and impact of FAS , the need for effective strategies for prevention , and the necessity for education to facilitate earlier diagnosis , referral and reporting of cases OBJECTIVE : To test the effectiveness of a brief intervention in the reduction of prenatal alcohol consumption  by women when a partner is included . METHODS : R and omized trial of a single session brief intervention given by the study nurse or principal investigator for 304 pregnant women and their partners . The women had positive T-ACE ( Tolerance , Annoyed , Cut down , Eye-opener , an alcohol screening test ) results and were at risk for alcohol consumption while pregnant . All completed initial diagnostic and postpartum interviews . RESULTS : Fewer than 20 % of participants ( median 11.5 weeks of gestation ) were abstinent at study enrollment , averaging more than 1.5 drinks per episode . Nearly 30 % had 2 or more drinks at a time while pregnant . Prenatal alcohol use declined in both the treatment and control groups after study enrollment , based on a 95 % follow-up rate . Factors associated with increased prenatal alcohol use after r and omization included more years of education , extent of previous alcohol consumption , and temptation to drink in social situations . Brief interventions for prenatal alcohol reduced subsequent consumption most significantly for the women with the highest consumption initially ( regression coefficient , b = −0.163 , st and ard error ( b ) = 0.063 , P < .01 ) . Moreover , the effects of the brief intervention were significantly enhanced when a partner participated ( b = −0.932 , st and ard error ( b ) = 0.468 ) , P < .05 ) . CONCLUSION : Pregnant women with the highest levels of alcohol use reduced their drinking most after a brief intervention that included their partners . Recommendations include consistent screening for prenatal alcohol use followed by diagnostic assessment when indicated , and if confirmed by other studies , a patient-partner brief intervention for the heaviest drinkers . LEVEL OF EVIDENCE : OBJECTIVE To evaluate the 3 alcohol consumption questions from the Alcohol Use Disorders Identification Test ( AUDIT-C ) as a brief screening test for heavy drinking and /or active alcohol abuse or dependence . METHODS Patients from 3 Veterans Affairs general medical clinics were  mailed question naires . A r and om , weighted sample of Health History Question naire respondents , who had 5 or more drinks over the past year , were eligible for telephone interviews ( N = 447 ) . Heavy drinkers were over sample d 2:1 . Patients were excluded if they could not be contacted by telephone , were too ill for interviews , or were female ( n = 54 ) .  Areas under receiver operating characteristic curves ( AUROCs ) were used to compare mailed alcohol screening question naires ( AUDIT-C and full AUDIT ) with 3 comparison st and ards based on telephone interviews : ( 1 ) past year heavy drinking ( > 14 drinks/week or > or = 5 drinks/ occasion ) ; ( 2 ) active alcohol abuse or dependence according to the Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition , criteria ; and ( 3 ) either . RESULTS Of 393 eligible patients , 243 ( 62 % ) completed AUDIT-C and interviews . For detecting heavy drinking , AUDIT-C had a higher AUROC than the full AUDIT ( 0.891 vs 0.881 ; P = .03 ) . Although the full AUDIT performed better than AUDIT-C for detecting active alcohol abuse or dependence ( 0.811 vs 0.786 ; P<.001 ) , the 2 question naires performed similarly for detecting heavy drinking and /or active abuse or dependence ( 0.880 vs 0.881 ) . CONCLUSIONS Three questions about alcohol consumption  ( AUDIT-C ) appear to be a practical , valid primary care screening test for heavy drinking and /or active alcohol abuse or dependence BACKGROUND the purpose of this study was to assess the test-retest reliability of newly introduced or revised modules of the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV ( AUDADIS-IV ) , including alcohol consumption , tobacco use , family history of depression , and selected DSM-IV axis I and II psychiatric disorders . METHODS kappa and intraclass correlation coefficients were calculated for the AUDADIS-IV modules using a test-retest design among a total of 2657 respondents , in subsets of approximately 400 , r and omly drawn from the National Epidemiologic Survey on Alcohol and Related Conditions ( NESARC ) . RESULTS reliabilities for alcohol consumption , tobacco use and family history of major depression measures were good to excellent , while reliabilities for selected DSM-IV axis I and II disorders were fair to good . The reliabilities of dimensional symptom scales of DSM-IV axis I and axis II disorders exceeded those of their dichotomous diagnostic counterparts and were generally in the good to excellent range . CONCLUSIONS the high reliability of alcohol consumption , tobacco use , family history of depression and psychiatric disorder modules found in this study suggests that the AUDADIS-IV can be a useful tool in various research setting s , particularly in studies of the general population , the target population for which it was design ed BACKGROUND The objective of this study was to determine whether there was an association between  mothers ' light drinking during pregnancy and risk of behavioural problems , and cognitive deficits in their children at age 3 years . METHODS Data from the first two sweeps of the nationally representative prospect i ve UK Millennium Cohort study were used . Drinking patterns during pregnancy and behavioural and cognitive outcomes were assessed during interviews and home visits . Behavioural problems were indicated by scores falling above defined clinical ly relevant cut-offs on the parent-report version of the Strengths and Difficulties Question naire  ( SDQ ) . Cognitive ability was assessed using the naming vocabulary subscale from the British Ability Scale ( BAS ) and the Bracken School Readiness Assessment ( BSRA ) . RESULTS There was a J-shaped relationship between mothers drinking during pregnancy and the likelihood of high scores ( above the cut-off ) on the total difficulties scale of the SDQ and the conduct problems , hyperactivity and emotional symptom SDQ subscales .  Children born to light drinkers were less likely to score above the cut-offs compared with children of abstinent mothers . Children born to heavy drinkers were more likely to score above the cut-offs compared with children of abstinent mothers . Boys born to mothers who had up to 1 - 2 drinks per week or per occasion were less likely to have conduct problems ( OR 0.59 , 95 % CI 0.45 - 0.77 ) and hyperactivity ( OR 0.71 , 95 % CI 0.54 - 0.94 ) . These effects remained in fully adjusted models . Girls were less likely to have emotional symptoms ( OR 0.72 , 95 % CI 0.51 - 1.01 ) and peer problems ( OR 0.68 , 95 % CI 0.52 - 0.92 ) compared with those born to abstainers . These effects were attenuated in fully adjusted models . Boys born to light drinkers had higher cognitive ability test scores [ st and ard deviations , ( 95 % CI ) ] BAS 0.15 ( 0.08 - 0.23 ) BSRA 0.24 ( 0.16 - 0.32 ) compared with boys born to abstainers . The difference for BAS was attenuated on adjustment for socio-economic factors , whilst the difference for BSRA remained statistically significant . CONCLUSIONS Children born to mothers who drank up to 1 - 2 drinks per week or per occasion during pregnancy were not at increased risk of clinical ly relevant behavioural difficulties or cognitive deficits compared with children of abstinent mothers . Heavy drinking during pregnancy appears to be associated with behavioural problems and cognitive deficits in offspring at age 3 years whereas light drinking does not Diagnosis is a critical component of health care , and clinicians , policymakers , and patients routinely face a range of questions regarding diagnostic tests . They want to know whether testing improves outcome ; what test to use , purchase , or recommend in practice guidelines ; and how to interpret test results . Well- design ed  diagnostic test accuracy studies can help in making these decisions , provided that they transparently and fully report their participants , tests , methods , and results as facilitated , for example , by the STARD ( St and ards for Reporting of Diagnostic Accuracy ) statement ( 1 ) . That 25-item checklist was published in many journals and is now adopted by more than 200 scientific journals worldwide . As in other areas of science , systematic review s and meta- analysis of accuracy studies can be used to obtain more precise estimates when small studies addressing the same test and patients in the same setting are available . Review s can also be useful to establish whether and how scientific findings vary by particular subgroups , and may provide summary estimates with a stronger generalizability than estimates from a single study . Systematic review s may help identify the risk for bias that may be present in the original studies and can be used to address questions that were not directly considered in the primary studies , such as comparisons between tests . The Cochrane Collaboration is the largest international organization preparing , maintaining , and promoting systematic review s to help people make well-informed decisions about health care ( 2 ) . The Collaboration decided in 2003 to make preparations for including systematic review s of diagnostic test accuracy in their Cochrane Data base of Systematic Review s. To enable this , a working group ( Appendix ) . was formed to develop methodology , software , and a h and book The first diagnostic test accuracy review was published in the Cochrane Data base in October 2008 . In this paper , we review recent method ological developments concerning problem formulation , location of literature , quality assessment , and meta- analysis of diagnostic accuracy studies by using our experience from the work on the Cochrane H and book . The information presented here is based on the recent literature and up date s previously published guidelines by Irwig and colleagues ( 3 ) . Definition of the Objectives of the Review Diagnostic test accuracy refers to the ability of a test to distinguish between patients with disease ( or more generally , a specified target condition ) and those without . In a study of test accuracy , the results of the test under evaluation , the index test , are compared with those of the reference st and ard determined in the same patients . The reference st and ard is an agreed-on and accurate method for identifying patients who have the target condition . Test results are typically categorized as positive or negative for the target condition . By using such binary test outcomes , the accuracy is most often expressed as the test 's sensitivity ( the proportion of patients with positive results on the reference st and ard that are also positive on the index test ) and specificity ( the proportion of patients with negative results on the reference st and ard that are also negative on the index test ) . Other measures have been proposed and are in use ( 46 ) . It has long been recognized that test accuracy is not a fixed property of a test . It can vary between patient subgroups , with their spectrum of disease , with the clinical setting , or with the test interpreters and may depend on the results of previous testing . For this reason , inclusion of these elements in the study question is essential . In order to make a policy decision to promote use of a new index test , evidence is required that using the new test increases test accuracy over other testing options , including current practice , or that the new test has equivalent accuracy but offers other advantages ( 79 ) . As with the evaluation of interventions , systematic review s need to include comparative analyses between alternative testing strategies and should not focus solely on evaluating the performance of a test in isolation . In relation to the existing situation , 3 possible roles for a new test can be defined : replacement , triage , and add-on ( 7 ) . If a new test is to replace an existing test , then comparing the accuracy of both tests on the same population and with the same reference st and ard provides the most direct evidence . In triage , the new test is used before the existing test or testing pathway , and only patients with a particular result on the triage test continue the testing pathway . When a test is needed to rule out disease in patients who then need no further testing , a test that gives a 
    Output:
    
For life-time alcohol dependency the AUDIT at score > or=8 performed poorly .
T-ACE , TWEAK and AUDIT-C show promise for screening for risk drinking , and AUDIT-C may also be useful for identifying alcohol dependency or abuse .