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Adjusting for self\u2010reported alcohol use, we conducted an individual participant data (IPD) meta\u2010analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self\u2010reporting unhealthy alcohol consumption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test\u2014Consumption (AUDIT\u2010C) positive scores (\u22653 for women and \u22654 for men) and PEth measurements. We conducted 1\u2010step IPD meta\u2010analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race\/ethnicity, and age) and biologic (body mass index\u2014BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger\u2010prick blood collection) variables with PEth sensitivity (PEth\u22658\u00a0ng\/ml), adjusting for the level of self\u2010reported alcohol use using the AUDIT\u2010C score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race\/ethnicity. PEth sensitivity (i.e., \u22658\u00a0ng\/ml) was 81.8%. After adjusting for AUDIT\u2010C, we found no associations of sex, age, race\/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race\/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14611","type":"journal-article","created":{"date-parts":[[2021,4,10]],"date-time":"2021-04-10T14:38:25Z","timestamp":1618065505000},"page":"1166-1187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta\u2010analysis"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2697-8264","authenticated-orcid":false,"given":"Judith A.","family":"Hahn","sequence":"first","affiliation":[{"name":"Department of Medicine University of California, San Francisco San Francisco CA USA"},{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco San Francisco CA 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