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Usefulness of indirect alcohol biomarkers for predicting recidivism of drunk-driving among previously convicted drunk-driving offenders: results from the Recidivism Of Alcohol-impaired Driving (ROAD) study

(2014) ADDICTION. 109(1). p.71-78
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Abstract
Aim: In several European countries, drivers under the influence (DUI), suspected of chronic alcohol abuse are referred for medical and psychological examination. This study (the ROAD study, or Recidivism Of Alcohol-impaired Driving) 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 Belgium. 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 (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(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(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 index25%; 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.
Keywords
carbohydrate-deficient transferrin, driver's licence, Alcoholism, drunk-driving, MARKERS, CONSUMPTION, DRINKING, PROGRAM, CDT, DUI RECIDIVISM, DRIVERS, liver disease, logistic regression, transferrin, CARBOHYDRATE-DEFICIENT TRANSFERRIN, GAMMA-GLUTAMYL-TRANSFERASE

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Chicago
Maenhout, Thomas, Anneleen Poll, Tijl Vermassen, Marc De Buyzere, and Joris Delanghe. 2014. “Usefulness of Indirect Alcohol Biomarkers for Predicting Recidivism of Drunk-driving Among Previously Convicted Drunk-driving Offenders: Results from the Recidivism Of Alcohol-impaired Driving (ROAD) Study.” Addiction 109 (1): 71–78.
APA
Maenhout, Thomas, Poll, A., Vermassen, T., De Buyzere, M., & Delanghe, J. (2014). Usefulness of indirect alcohol biomarkers for predicting recidivism of drunk-driving among previously convicted drunk-driving offenders: results from the Recidivism Of Alcohol-impaired Driving (ROAD) study. ADDICTION, 109(1), 71–78.
Vancouver
1.
Maenhout T, Poll A, Vermassen T, De Buyzere M, Delanghe J. Usefulness of indirect alcohol biomarkers for predicting recidivism of drunk-driving among previously convicted drunk-driving offenders: results from the Recidivism Of Alcohol-impaired Driving (ROAD) study. ADDICTION. 2014;109(1):71–8.
MLA
Maenhout, Thomas, Anneleen Poll, Tijl Vermassen, et al. “Usefulness of Indirect Alcohol Biomarkers for Predicting Recidivism of Drunk-driving Among Previously Convicted Drunk-driving Offenders: Results from the Recidivism Of Alcohol-impaired Driving (ROAD) Study.” ADDICTION 109.1 (2014): 71–78. Print.
@article{4237323,
  abstract     = {Aim: In several European countries, drivers under the influence (DUI), suspected of chronic alcohol abuse are referred for medical and psychological examination. This study (the ROAD study, or Recidivism Of Alcohol-impaired Driving) 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 Belgium. 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 (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{\textlangle}0.001), ln(GT) (P{\textlangle}0.01) and ln(ALT) (P{\textlangle}0.05) were the best biochemical predictors of recidivism of drunk-driving. The ROAD index (which includes ln(\%CDT), ln(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 index25\%; third tertile) could be distinguished from drivers with an intermediate risk (16\%ROAD index{\textlangle}25\%; second tertile; P{\textlangle}0.001) and a low recidivism risk (ROAD index{\textlangle}16\%; first tertile;P{\textlangle}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.},
  author       = {Maenhout, Thomas and Poll, Anneleen and Vermassen, Tijl and De Buyzere, Marc and Delanghe, Joris},
  issn         = {0965-2140},
  journal      = {ADDICTION},
  language     = {eng},
  number       = {1},
  pages        = {71--78},
  title        = {Usefulness of indirect alcohol biomarkers for predicting recidivism of drunk-driving among previously convicted drunk-driving offenders: results from the Recidivism Of Alcohol-impaired Driving (ROAD) study},
  url          = {http://dx.doi.org/10.1111/add.12372},
  volume       = {109},
  year         = {2014},
}

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