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APPENDIX I: SCREENING INSTRUMENTS

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SCREENING INSTRUMENTS: ALCOHOL ABUSE

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SENSITIVITY AND SPECIFICITY OF SCREENING TESTS FOR PROBLEM DRINKING
Instrument Name Screening Questions/Scoring Threshold Score Sensitivity/Specificity (%) Source
CAGEa See Screening Procedures for Problem Drinking

>1

>2

>3

77/58

53/81

29/92

Am J Psychiatry. 1974;131:1121

J Gen Intern Med. 1998;13:379

AUDIT See Screening Procedures for Problem Drinking

>4

>5

>6

87/70

77/84

66/90

BMJ. 1997;314:420

J Gen Intern Med. 1998;13:379

aThe CAGE may be less applicable to binge drinkers (e.g., college students), the elderly, and minority populations.

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SCREENING PROCEDURES FOR PROBLEM DRINKING
1. CAGE screening testa
Have you ever felt the need to Cut down on drinking?
Have you ever felt Annoyed by criticism of your drinking?
Have you ever felt Guilty about your drinking?
Have you ever taken a morning Eye opener?
INTERPRETATION: Two “yes” answers are considered a positive screen. One “yes” answer should arouse a suspicion of alcohol abuse.
2. The Alcohol Use Disorder Identification Test (AUDIT)b (Scores for response categories are given in parentheses. Scores range from 0 to 40, with a cutoff score of ≥5 indicating hazardous drinking, harmful drinking, or alcohol dependence.)
 1) How often do you have a drink containing alcohol?
  (0) Never (1) Monthly or less (2) Two to four times a month (3) Two or three times a week (4) Four or more times a week
 2) How many drinks containing alcohol do you have on a typical day when you are drinking?
  (0) 1 or 2 (1) 3 or 4 (2) 5 or 6 (3) 7 to 9 (4) 10 or more
 3) How often do you have 6 or more drinks on 1 occasion?
  (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily
 4) How often during the last year have you found that you were not able to stop drinking once you had started?
  (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily
 5) How often during the last year have you failed to do what was normally expected of you because of drinking?
  (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily
 6) How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?
  (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily
 7) How often during the last year have you had a feeling of guilt or remorse after drinking?
  (0) Never (1) Less than monthly (2) Monthly (3) Weekly (4) Daily or almost daily
 8) How often during the last year have you been unable to remember what happened the night before because you had been drinking?
  (0) Never (1) ...

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