Concordance Between the Alcohol Use Disorders Identification Test and Phosphatidylethanol: A Narrative Review

Abstract

Aims: To evaluate the concordance between the Alcohol Use Disorders Identification Test (AUDIT) and phosphatidylethanol (PEth) as measures of alcohol consumption.

Methods: Narrative review of studies assessing associations between the full 10-item AUDIT and PEth. Evidence was synthesized with emphasis on correlation, agreement, and sources of discordance.

Results: Across clinical and population-based studies, correlations between AUDIT and PEth are consistently moderate (r ≈ 0.50–0.65). A meta-analytic approximation yields a pooled correlation of r ≈ 0.57. Despite this association, discordance is observed in approximately 20–30% of individuals. Elevated PEth with low AUDIT scores suggests underreporting, whereas high AUDIT with low PEth reflects differences in timeframe or construct.

Conclusions: AUDIT and PEth capture related but distinct dimensions of alcohol use. Their moderate concordance reflects differences in behavioral versus biochemical measurement. Combined use improves detection of alcohol consumption and should be considered in clinical and research settings.