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Screening for alcohol abuse using CAGE scores and likelihood ratios
D G Buchsbaum1, R G Buchanan, R M Centor
1Medical College of Virginia, Richmond 23298.
Annals of Internal Medicine
|November 15, 1991
Summary
The CAGE questionnaire effectively screens for alcohol abuse or dependence in medical outpatients. A score of 2 or higher shows high accuracy, with likelihood ratios improving risk assessment.
Area of Science:
- Addiction Medicine
- Psychiatry
- Primary Care Screening
Background:
- Alcohol abuse and dependence are significant public health concerns.
- Effective screening tools are crucial for early identification in clinical settings.
Purpose of the Study:
- To evaluate the diagnostic performance of the CAGE questionnaire.
- To assess its ability to differentiate patients with and without alcohol use disorders.
Main Methods:
- Cross-sectional study in an urban university hospital outpatient setting.
- Used the CAGE questionnaire and the diagnostic interview schedule's alcohol module.
- Analyzed sensitivity, specificity, ROC curve, and likelihood ratios for CAGE scores.
Main Results:
- 36% of patients met criteria for alcohol abuse or dependence.
- A CAGE score of ≥2 yielded 74% sensitivity and 91% specificity.
- Area under the ROC curve was 0.89; likelihood ratios increased with CAGE score.
Conclusions:
- The CAGE questionnaire is a valuable tool for screening alcohol use disorders.
- Likelihood ratios derived from CAGE scores enhance clinical risk estimation.
- Clinicians can better assess patient risk for alcohol problems using CAGE.
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