Screening for Problem Drinking
Comparison of CAGE and AUDIT
Article first published online: 27 DEC 2001
1998 by the Society of General Internal Medicine
Journal of General Internal Medicine
Volume 13, Issue 6, pages 379–389, June 1998
How to Cite
Bradley, K. A., Bush, K. R., McDonell, M. B., Malone, T., Fihn, S. D. and For The Ambulatory Care Quality Improvement Project (1998), Screening for Problem Drinking . Journal of General Internal Medicine, 13: 379–389. doi: 10.1046/j.1525-1497.1998.00118.x
- Issue published online: 27 DEC 2001
- Article first published online: 27 DEC 2001
- Cited By
- alcohol abuse;
- alcohol drinking
To compare self-administered versions of three questionnaires for detecting heavy and problem drinking: the CAGE, the Alcohol Use Disorders Identification Test (AUDIT), and an augmented version of the CAGE.
Three Department of Veterans Affairs general medical clinics.
Random sample of consenting male outpatients who consumed at least 5 drinks over the past year (“drinkers”). Heavy drinkers were oversampled.
An augmented version of the CAGE was included in a questionnaire mailed to all patients. The AUDIT was subsequently mailed to “drinkers.” Comparison standards, based on the tri-level World Health Organization alcohol consumption interview and the Diagnostic Interview Schedule, included heavy drinking (>14 drinks per week typically or ≥5 drinks per day at least monthly) and active DSM-IIIR alcohol abuse or dependence (positive diagnosis and at least one alcohol-related symptom in the past year). Areas under receiver operating characteristic curves (AUROCs) were used to compare screening questionnaires.
Of 393 eligible patients, 261 (66%) returned the AUDIT and completed interviews. For detection of active alcohol abuse or dependence, the CAGE augmented with three more questions (AUROC 0.871) performed better than either the CAGE alone or AUDIT (AUROCs 0.820 and 0.777, respectively). For identification of heavy-drinking patients, however, the AUDIT performed best (AUROC 0.870). To identify both heavy drinking and active alcohol abuse or dependence, the augmented CAGE and AUDIT both performed well, but the AUDIT was superior (AUROC 0.861).
For identification of patients with heavy drinking or active alcohol abuse or dependence, the self-administered AUDIT was superior to the CAGE in this population.