Screening for problem drinking : Comparison of CAGE and AUDIT.

Area of Science:

• Clinical Medicine
• Psychiatry
• Public Health

Background:

• Heavy and problem drinking are significant public health concerns.
• Effective screening tools are crucial for early detection and intervention in clinical settings.

Purpose of the Study:

• To compare the self-administered CAGE, Alcohol Use Disorders Identification Test (AUDIT), and an augmented CAGE for detecting heavy and problem drinking.
• To evaluate the diagnostic accuracy of these questionnaires in a male outpatient population.

Main Methods:

• Cross-sectional survey conducted in three Department of Veterans Affairs general medical clinics.
• A random sample of male outpatients (n=261) who consumed at least 5 drinks in the past year participated.
• Screening questionnaires (CAGE, augmented CAGE, AUDIT) were compared against established diagnostic standards using receiver operating characteristic curves (AUROCs).

Main Results:

• For detecting active alcohol abuse or dependence, the augmented CAGE showed the highest AUROC (0.871), followed by CAGE (0.820) and AUDIT (0.777).
• For identifying heavy drinking, the AUDIT performed best (AUROC 0.870).
• For identifying both heavy drinking and active alcohol abuse/dependence, the AUDIT was superior (AUROC 0.861) to the augmented CAGE.

Conclusions:

• The self-administered AUDIT is a superior tool for identifying patients with heavy drinking or active alcohol abuse/dependence compared to the CAGE in this male outpatient population.
• The choice of screening tool may depend on the specific diagnostic goal (heavy drinking vs. abuse/dependence).