ArticleAlcohol, clinical & experimental research2026
Exploring Phosphatidylethanol Cutoffs for Self-Reported Unhealthy Alcohol Use: An International Multi-Site Analysis.
Article in Alcohol, clinical & experimental research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
31 authors.
Funding
Abstract
backgroundUnhealthy alcohol use is a preventable cause of morbidity and mortality, yet screening is hampered by inaccurate reporting. Phosphatidylethanol (PEth) is a biomarker that quantifies total drinking over the past 2-4 weeks, but PEth cutoffs for unhealthy drinking have not been well-examined.
methodsWe pooled data from 22 studies (11,088 persons globally) that previously collected PEth and self-reported alcohol use. Within a 90% training set, we calculated PEth cutoffs per Youden's J in 1000 bootstrapped samples and explored differences by region, age, sex, race/ethnicity, body mass index (BMI), HIV status, hemoglobin level, and an indirect serum marker of liver fibrosis, FIB-4. For each cutoff, we estimated sensitivity, specificity, and positive and negative predictive values in a 10% validation dataset. We used two definitions for self-reported unhealthy drinking per Alcohol Use Disorders Identification Test Consumption (AUDIT-C) and National Institute on Alcohol Abuse and Alcoholism (NIAAA).
resultsOptimal PEth cutoffs using self-reported alcohol use as the reference standard differed substantially by region. The cutoff for AUDIT-C-measured unhealthy alcohol use in studies from the United States (US) was 14.0 ng/mL (95% CI: 12.3-18.6) with 73.0% sensitivity (95% CI: 67.3-79.1) and 77.4% specificity (95% CI: 73.2-81.4); and was 65.7 ng/mL (95% CI 19.3-90.7) in studies from Africa, with 71.7% sensitivity (95% CI: 64.4-78.7) and 65.2% specificity (95% CI: 58.1-72.7). Cutoffs for AUDIT-C did not differ between subgroups in the US, but within Africa, cutoffs were higher for men and lower for those with BMI ≥ 25 kg/m
conclusionsUsing self-report as the reference standard, PEth cutoffs differed substantially by region and by some other characteristics, which may be attributable to differences in PEth formation, elimination and/or reporting bias. Further work using objective gold-standard measures of alcohol consumption is needed for more definitive conclusions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.