The validity of the Michigan Alcoholism Screening Test (MAST)

This review examines the validity of the Michigan Alcoholism Screening Test (MAST) as a screening instrument for alcohol problems. Studies that compare the MAST-questionnaire with other defined diagnostic criteria of alcohol problems were retrieved through MEDLINE and a cross-bibliographic check. A total of 20 validity studies were included. The studies varied considerably regarding the prevalence of alcohol problems, the diagnostic criteria, and the examined patient categories. The MAST compared with other diagnostic criteria of alcohol problems gave validity measures with the following span: predictive positive value (PVpos) 0.24-0.96, predictive negative value (PVneg) 0.78- approximately 1, sensitivity 0.36- approximately 1, and specificity 0.36-0.96. It appears that the PVneg are high. Except from one study, the sensitivities (0.57- approximately 1) are also high. The PVpos and the specificities show substantial variations. The variables that seem to have the largest influence on the PVpos seem to be the prevalence of alcohol problems, the diagnostic method against which the MAST-questionnaire is validated, and the populations on which the MAST is applied. The MAST should in the future be validated against internationally accepted diagnostic methods on populations with representative prevalences of alcohol problems.