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Alcoholism: the keys to the CAGE
Donald Lee Steinweg1, Heidi Worth2
1From the Department of Medicine, Walter Reed Army Medical Center, Washington, D.C. USA; From the Uniformed Services University of the Health Sciences, Washington, D.C. USA.
The American Journal of Medicine
|May 1, 1993
Summary
Screening for alcoholism using the CAGE questionnaire is more effective with an open-ended introduction. This method significantly improves the detection rate of alcohol use disorders compared to a quantitative drinking approach.
Area of Science:
- Medical Screening
- Alcohol Use Disorders
- Clinical Psychology
Background:
- Alcoholism poses a significant public health challenge.
- Effective screening tools are crucial for early detection and intervention.
- The CAGE questionnaire is a widely used screening tool for alcohol dependence.
Purpose of the Study:
- To evaluate the impact of different introductions on the efficiency of the CAGE questionnaire for alcoholism screening.
- To compare an open-ended introduction versus a quantitative drinking volume/frequency introduction.
Main Methods:
- Forty-three inpatient alcohol-dependent patients were recruited.
- Participants were randomized into two groups with different CAGE question introductions.
- An independent observer recorded CAGE scores.
Main Results:
- The open-ended introduction group (Group I) showed significantly higher rates of admitting to attempts to cut back (86%) and annoyance (49%) compared to the quantitative introduction group (Group II) (36% and 14%, respectively).
- Average CAGE scores were significantly higher in Group I (2.52) versus Group II (1.23).
- Sensitivity for detecting alcoholism (CAGE score ≥2) was 95% with the open-ended introduction versus 32% with the quantitative introduction.
Conclusions:
- An open-ended introduction dramatically enhances the sensitivity of the CAGE questionnaire for screening alcoholism.
- Inquiries focusing on drinking quantity and frequency prior to CAGE questions significantly reduce the tool's sensitivity.
- Optimizing screening question order is vital for accurate alcohol use disorder identification.