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Alcohol Clin Exp Res. 2001 Oct;25(10):1472-8.

Variations on the CAGE alcohol screening questionnaire: strengths and limitations in VA general medical patients.

Author information

1
Northwest Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, Washington, USA.

Abstract

BACKGROUND:

Several variations on the CAGE alcohol screening questionnaire have been recommended. This report evaluates modifications and additions to the CAGE.

METHODS:

Alcohol screening questionnaires were evaluated in male VA general medicine patients (n = 227; mean age, 65.8). Mailed questionnaires included two scoring options for the CAGE (standard and last-year time frames), questions about quantity and frequency of drinking, two questions about episodic heavy drinking, and the question "Have you ever had a drinking problem?" Main analyses compared alcohol screening questions, at various cut-points, to a gold standard of hazardous drinking during the past year (> or =14 drinks/week or > or =5 drinks on an occasion) and/or DSM-III-R alcohol abuse or dependence, based on standardized interviews.

RESULTS:

The CAGE questionnaire with a past-year time frame was much less sensitive (0.57 vs. 0.77) but more specific (0.82 vs. 0.59) than the standard CAGE for detecting hazardous drinking during the past year and/or DSM-III-R alcohol abuse or dependence. An eight-item questionnaire that included the standard CAGE was most sensitive (0.92) but had low specificity (0.50). A single question about the frequency of drinking > or =6 drinks on an occasion, included in the eight-item questionnaire, was both relatively sensitive (0.77) and specific (0.83).

CONCLUSION:

The CAGE questionnaire with a past-year time frame was an insensitive alcohol-screening test. An eight-item augmented version of the standard CAGE was the most sensitive. A question about the frequency of drinking > or =6 drinks on an occasion performed better than the standard CAGE, which made it the optimal brief screening test for at-risk drinking.

PMID:
11696667
[Indexed for MEDLINE]

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