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Usefulness of indirect alcohol biomarkers for predicting recidivism of drunk‐driving among previously convicted drunk‐driving offenders: results from the R ecidivism O f A lcohol‐impaired D riving (ROAD) study
Author(s) -
Maenhout Thomas M.,
Poll Anneleen,
Vermassen Tijl,
De Buyzere Marc L.,
Delanghe Joris R.
Publication year - 2014
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12372
Subject(s) - recidivism , drunk drivers , drunk driving , driving under the influence , alcohol , poison control , injury prevention , human factors and ergonomics , psychology , occupational safety and health , psychiatry , environmental health , medicine , chemistry , biochemistry , pathology
Aim In several E uropean countries, drivers under the influence ( DUI ), suspected of chronic alcohol abuse are referred for medical and psychological examination. This study (the ROAD study, or R ecidivism O f A lcohol‐impaired D riving) investigated the usefulness of indirect alcohol biomarkers for predicting drunk‐driving recidivism in previously convicted drunk‐driving offenders. Design, setting, participants and measurements The ROAD study is a prospective study (2009–13) that was performed on 517 randomly selected drivers in B elgium. They were convicted for drunk‐driving for which their licence was confiscated. The initial post‐arrest blood samples were collected and analysed for percentage carbohydrate‐deficient transferrin (% CDT ), transaminsase activities [alanine amino transferase ( ALT ), aspartate amino transferase ( AST )], gamma‐glutamyltransferase (γ GT ) and red cell mean corpuscular volume ( MCV ). The observation time for each driver was 3 years and dynamic. Findings A logistic regression analysis revealed that ln(% CDT ) ( P < 0.001), ln(γ GT ) ( P < 0.01) and ln( ALT ) ( P < 0.05) were the best biochemical predictors of recidivism of drunk‐driving. The ROAD index (which includes ln(% CDT ), ln(γ GT ), ‐ln( ALT ) and the sex of the driver) was calculated and had a significantly higher area under the receiver operator characteristic curve (0.71) than the individual biomarkers for drunk‐driving recidivism. Drivers with a high risk of recidivating ( ROAD index ≥ 25%; third tertile) could be distinguished from drivers with an intermediate risk (16% ≤ ROAD index < 25%; second tertile; P < 0.001) and a low recidivism risk ( ROAD index < 16%; first tertile ; P < 0.05). Conclusions Of all routinely used indirect alcohol markers, percentage of carbohydrate‐deficient transferrin is the major predictor of recidivism of drunk‐driving. The association with gamma‐glutamyltransferase, alanine amino transferase and the sex of the driver could have additional value for identifying drunk‐drivers at intermediate risk of recidivism. Non‐specific indirect alcohol markers, such as alanine amino transferase, gamma‐glutamyltransferase, aspartate amino transferase and red cell mean corpuscular volume have minimal added value to % carbohydrate‐deficient transferrin for distinguishing drunk drivers with a low or high risk of recidivism.