Citation

Boscolo-Berto R, Favretto D, Cecchetto G, Vincenti M, Kronstrand R, Ferrara SD, Viel G. Ther. Drug. Monit. 2014; 36(5): 560-575.

Affiliation

1Department of Cardiac, Thoracic and Vascular Sciences, Section of Legal Medicine and Toxicology, University Hospital of Padova, Via Falloppio 50, 35121 Padova, Italy 2Department of Chemistry, University of Torino, Via Giuria 7, 10125 Torino, Italy; and Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Torino, Italy. 3National Board of Forensic Medicine, Department of Forensic Genetics and Forensic Toxicology, SE-587 58 Linköping, Sweden.

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/FTD.0000000000000063

PMID

24577122

Abstract

BACKGROUND: To assess the debated diagnostic performance of ethyl glucuronide in the 3-cm proximal scalp hair fraction (HEtG) as a marker of chronic excessive drinking. METHODS: In July 2012/May 2013, after a systematic search through the Medline, Ovid/Embase, Web of Science and Scopus databases, 8 studies were included in the pooled analysis, that report raw single data on HEtG concentration and Self-reported Daily Alcohol Intake (SDAI). A Receiver Operating Characteristic curve analysis and a Spearman rank order correlation test were used. A meta-analysis was performed following the PRISMA and Cochrane recommendations, comprising quality and bias assessments. RESULTS: The pooled analysis showed that 30 pg/mg could be a useful cut-off value for HEtG to detect a SDAI > 60 g/day, and demonstrated a parabolic direct correlation between HEtG and SDAI data (rho 0.79; 95% CI 0.69-0.87; p<0.001). The meta-analysis found an overall HEtG sensitivity of 0.96 (95% CI 0.72-1.00) and specificity of 0.99 (95% 0.92-1.00); a nomogram to predict the post-test probability of exhibiting the targeted condition in the general population was built. Significant variability among the included studies was detected, which is mainly explained by true heterogeneity in the presence of publication bias. CONCLUSIONS: With the available data we conclude that HEtG is a promising marker for identifying chronic excessive drinking. Nonetheless, larger and well-designed population studies are required to draw any definitive conclusions on the significance and appropriateness of its application in the forensic setting.

Language: en