Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T18:41:16.497Z Has data issue: false hasContentIssue false
  • English
  • Français

Validity of the CAGE questionnaire in hospital

Published online by Cambridge University Press:  16 April 2020

Laurent Malet ,
Raymund Schwan ,
Didier Boussiron ,
Bruno Aublet-Cuvelier  and
Pierre-Michel Llorca
Laurent Malet*
Affiliation:
Centre Hospitalier Universitaire, Department of Psychiatry-B, rue Montalembert BP 69, 63003Clermont-Ferrand cedex 1, France
Raymund Schwan
Affiliation:
Centre Hospitalier Universitaire, Department of Psychiatry-B, rue Montalembert BP 69, 63003Clermont-Ferrand cedex 1, France
Didier Boussiron
Affiliation:
Centre Hospitalier Universitaire, Department of Psychiatry-B, rue Montalembert BP 69, 63003Clermont-Ferrand cedex 1, France
Bruno Aublet-Cuvelier
Affiliation:
CHU—Hotel-Dieu, Department of Public Health and Epidemiology, boulevard Leon Malfrey, 63058Clermont-Ferrand cedex, France
Pierre-Michel Llorca
Affiliation:
Centre Hospitalier Universitaire, Department of Psychiatry-B, rue Montalembert BP 69, 63003Clermont-Ferrand cedex 1, France
*
*Corresponding author. E-mail address: lmalet@chu-clermontferrand.fr (L. Malet).
Get access

Abstract

Objective

The CAGE questionnaire is considered a useful screening and case-finding tool for alcohol use disorders in clinical populations. Our objectives were to validate the French version of the CAGE against DSM-IV criteria and to assess performance of each item of the scale.

Method

Data were extracted from a hospital morbidity study conducted in central France. It concerned 5452 patients—48.5% men—in short and medium-stay units. Patients answered the CAGE questionnaire as a past-year assessment. The alcohol use disorders were diagnosed by the physicians using DSM-IV alcohol abuse or dependency criteria.

Results

The CAGE questionnaire for a cut-off of 2 had a sensitivity of 77% and a specificity of 94%. The CAGE test was more sensitive for patients diagnosed as alcohol-dependent than for alcohol abusers (61% vs. 84%) with the same specificity (94%). These values are close to those for the English-language CAGE. The first three items (CAG) were very similar, with sensitivity 70% and specificity 94%. The eye-opening question (E) differentiated sharply between abuse and dependency, with sensitivities of 18% and 46%, respectively. A questionnaire comprising only the CAG questions of the CAGE had properties similar to the full questionnaire.

Conclusion

CAGE is a good screening tool for alcohol abuse or alcohol dependency. Given the frequent—and insufficiently diagnosed—alcohol problems among inpatients, CAGE is indicated as a first-line tool for screening for the most severe alcohol use disorders in hospital. It should ideally be used systematically. A positive reply to any of the first three items should alert the clinician and prompt further investigation.

Keywords

CageHospitalAlcohol abuseAlcohol dependence
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 7 , November 2005 , pp. 484 - 489
Copyright
Copyright © Elsevier SAS 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aertgeerts, B.Buntinx, F.Ansoms, S.Fevery, J.Screening properties of questionnaires and laboratory tests for the detection of alcohol abuse or dependence in a general practice population. Br J Gen Pract, 2001; 51: 464206–217Google ScholarPubMed
American Psychiatric Association DSM IV: Diagnostic and statistical manual of mental disorders. 4th edWashington, DC: American Psychiatric Association; 1994.Google Scholar
Beresford, T.P.Screening for alcohol abuse using the cage questionnaire. Am J Med 1987;83:(4)805CrossRefGoogle ScholarPubMed
Bisson, J.Nadeau, L.Demers, A.The validity of the cage scale to screen for heavy drinking and drinking problems in a general population survey. Addiction, 1999; 94: 5715–722CrossRefGoogle Scholar
Buchsbaum, D.G.Buchanan, R.G.Centor, R.M.Schnoll, S.H.Lawton, M.J.Screening for alcohol abuse using cage scores and likelihood ratios. Ann Intern Med, 1991; 115: 10774–777CrossRefGoogle ScholarPubMed
Bush, B.Shaw, S.Cleary, P.Delbanco, T.L.Aronson, M.D.Screening for alcohol abuse using the cage questionnaire. Am J Med, 1987; 82: 2231–235CrossRefGoogle ScholarPubMed
Bush, K.Kivlahan, D.R.McDonell, M.B.Fihn, S.D.Bradley, K.A.The audit alcohol consumption questions (Audit-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (Acquip). Alcohol use disorders identification test. Arch Intern Med, 1998; 158: 161789–1795CrossRefGoogle ScholarPubMed
Cherpitel, C.J.Emergency room and primary care services utilization and associated alcohol and drug use in the United States general population. Alcohol Alcohol, 1999; 34: 4581–589CrossRefGoogle ScholarPubMed
Crowe, R.R.Kramer, J.R.Hesselbrock, V.Manos, G.Bucholz, K.K.The Utility of the brief mast' and the cage' in identifying alcohol problems: results from national high-risk and community samples. Arch Fam Med, 1997; 6: 5477–483CrossRefGoogle ScholarPubMed
Ewing, J.A.Detecting alcoholism. The cage questionnaire. JAMA, 1984; 252: 141905–1907CrossRefGoogle ScholarPubMed
Fiellin, D.A.Reid, M.C.O'Connor, P.G.Screening for alcohol problems in primary care: a systematic review. Arch Intern Med, 2000; 160: 131977–1989CrossRefGoogle ScholarPubMed
Grant, B.F.Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the national longitudinal alcohol epidemiologic survey. J Stud Alcohol, 1997; 58: 5464–473CrossRefGoogle ScholarPubMed
Hodgson, R.Alwyn, T.John, B.Thom, B.Smith, A.The fast alcohol screening test. Alcohol Alcohol, 2002; 37: 161–66CrossRefGoogle ScholarPubMed
King, M.At risk drinking among general practice attenders: validation of the cage questionnaire. Psychol Med, 1986; 16: 1213–217CrossRefGoogle ScholarPubMed
Lloyd, G.Chick, J.Crombie, E.Screening for problem drinkers among medical inpatients. Drug Alcohol Depend, 1982; 10: 4355–359CrossRefGoogle ScholarPubMed
Magruder-Habib, K.Stevens, H.A.Alling, W.C.Relative performance of the mast, vast, and cage versus DSM-III-R criteria for alcohol dependence. J Clin Epidemiol, 1993; 46: 5435–441CrossRefGoogle ScholarPubMed
Maisto, S.A.Connors, G.J.Allen, J.P.Contrasting self-report screens for alcohol problems: a review. Alcohol Clin Exp Res, 1995; 19: 61510–1516CrossRefGoogle ScholarPubMed
Mayfield, D.McLeod, G.Hall, P.The cage questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry, 1974; 131: 101121–1123Google ScholarPubMed
Moore, R.D.Bone, L.R.Geller, G.Mamon, J.A.Stokes, E.J.Levine, D.M.Prevalence, detection, and treatment of alcoholism in hospitalized patients. JAMA, 1989; 261: 3403–407CrossRefGoogle ScholarPubMed
Niles, B.L.McCrady, B.S.Detection of alcohol problems in a hospital setting. Addict Behav, 1991; 16: 5223–233CrossRefGoogle ScholarPubMed
Perdrix, A.Decrey, H.Pecoud, A.Burnand, B.Yersin, B.Detection of alcoholism in the medical office: applicability of the cage questionnaire by the practicing physician. Schweiz Med Wochenschr 1995;125:(38)17721778Group of Medical Practitioners PmuGoogle ScholarPubMed
Piccinelli, M.Tessari, E.Bortolomasi, M.Piasere, O.Semenzin, M.Garzotto, N., et al.Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study. BMJ, 1997; 314: 7078420–424CrossRefGoogle ScholarPubMed
Reynaud, M.Malet, L.Facy, F.Glanddier, P.Hospital morbidity of alcohol use disorders in the center of France. Alcohol Clin Exp Res, 2000; 24: 71057–1062CrossRefGoogle Scholar
Reynaud, M.Parquet, J.P.Les personnes en difficulté avec l'alcool. Usage, usage nocif, dépendance: propositions. Paris: CFES: 1999Google Scholar
Rueff, B.Crnac, J.Darne, B.Detection of alcoholic patients using the systematic cage autoquestionnaire. In out patients. Presse Med, 1989; 18: 331654–1656Google ScholarPubMed
Saunders, J.B.Aasland, O.G.Babor, T.F.de la Fuente, J.R.Grant, M.Development of the alcohol use disorders identification test (Audit): WHO collaborative project on early detection of persons with harmful alcohol consumption—II. Addiction, 1993; 88: 6791–804CrossRefGoogle Scholar
Schofield, A.The cage questionnaire and psychological health. Br J Addict, 1988; 83: 7761–764CrossRefGoogle ScholarPubMed
Seppa, K.Lepisto, J.Sillanaukee, P.Five-shot questionnaire on heavy drinking. Alcohol Clin Exp Res, 1998; 22: 81788–1791CrossRefGoogle ScholarPubMed
Steinweg, D.L.Worth, H.Alcoholism: the keys to the cage. Am J Med, 1993; 94: 5520–523CrossRefGoogle ScholarPubMed
Tempier, R.P.Screening for Risk Factors for Alcohol Consumption in the Quebec Health Survey. Can J Public Health, 1996; 87: 3183–186Google ScholarPubMed
Truan, P.Gmel, G.Francois, Y.Janin, B.Screening for problem alcohol drinking in the Swiss population: comparison between an Ispa-developed instrument and the cage questionnaire. Schweiz Med Wochenschr 1997;127:(18)753761The Swiss Institute for the Prevention of AlcoholismGoogle ScholarPubMed
World Health Organisation The ICD-10 classfication of mental and behavioural disorders. 1992Google Scholar
Submit a response

Comments

No Comments have been published for this article.