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Ann Intern Med. 1991 Nov 15;115(10):774-7.

Screening for alcohol abuse using CAGE scores and likelihood ratios.

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  • 1Medical College of Virginia, Richmond 23298.

Abstract

OBJECTIVE:

To assess the performance of the CAGE (acronym referring to four questions, see below) questionnaire in discriminating between medicine outpatients with and without an alcohol abuse or dependence disorder.

DESIGN:

A cross-sectional design of a sample of consecutive patients who received both the alcohol module of the diagnostic interview schedule and the CAGE (Cut down, Annoyed, Guilty, Eye-opener) screening questionnaire.

SETTING:

The outpatient medical practice of an urban university teaching hospital.

PATIENTS:

All patients 18 years or older who signed a consent form approved by the university's institutional review board.

MEASUREMENT:

Calculation of the sensitivity, specificity, receiver operating characteristic (ROC) curve, and likelihood ratio for CAGE scores of 0 to 4.

RESULTS:

Thirty-six percent of the sample group met criteria for a history of alcohol abuse or dependence. A CAGE score of 2 or more was associated with a sensitivity and specificity of 74% and 91%. The calculated area under the ROC curve was 0.89, whereas the likelihood ratios for CAGE scores of 0 to 4 were 0.14, 1.5, 4.5, 13, and 100, respectively. These ratios were associated with posterior probabilities for an abuse or dependence disorder of 7%, 46%, 72%, 88%, and 98%, respectively.

CONCLUSION:

Clinicians can improve their ability to estimate a patient's risk for an alcohol abuse or dependence disorder using likelihood ratios for CAGE scores.

Comment in

  • Interpreting CAGE scores. [Ann Intern Med. 1992]
  • Interpreting CAGE scores. [Ann Intern Med. 1992]
PMID:
1929025
[PubMed - indexed for MEDLINE]
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