Saitz R, Lepore M F, Sullivan L M, Amaro H, Samet J H
Department of Medicine, Boston University School of Medicine, Boston Medical Center, Mass 02118-2393. USA.
Arch Intern Med. 1999 Apr 12;159(7):718-24. doi: 10.1001/archinte.159.7.718.
Brief alcoholism screening questionnaires have not been adequately studied in the rapidly growing Latino population living in the United States.
To assess (1) the prevalence of alcoholism and (2) the performance of 2 alcohol screening instruments in Latinos.
We performed a cross-sectional interview study in an urban teaching hospital-based primary care practice. Consecutive self-identified Latino subjects provided informed consent. All subjects were interviewed in English or Spanish using 2 alcoholism screening tools, the CAGE (or the Spanish version, the 4M), and the Alcohol Use Disorders Identification Test, and a criterion standard for the diagnosis of alcohol abuse and dependence, the Composite International Diagnostic Interview.
Of 210 subjects interviewed, 36% had a lifetime diagnosis of alcohol abuse or dependence by the criterion standard. Thirty-one percent were currently drinking hazardous amounts of alcohol. A CAGE (4M) score of 1 or more was 92% sensitive and 74% specific, and a score of 2 or more was 80% sensitive and 93% specific for a lifetime diagnosis of alcohol abuse or dependency. CAGE (4M) scores of 0, 2, 3, and 4 were associated with likelihood ratios (0.1, 4.8, 18.5, and 36.8, respectively) that resulted in substantial changes from pretest (36%) to posttest probability (to 6%, 73%, 91%, and 95%, respectively) of a diagnosis of alcohol abuse or dependency. At the standard cutoff point, the Alcohol Use Disorders Identification Test detected only 51% of subjects with alcohol disorders.
In Latinos in primary care settings, alcohol abuse and dependence are common and the CAGE (4M) is a brief, valid, screening tool for detecting alcohol use disorders.
针对生活在美国的迅速增长的拉丁裔人群，简短的酒精中毒筛查问卷尚未得到充分研究。
评估（1）酒精中毒的患病率，以及（2）两种酒精筛查工具在拉丁裔人群中的表现。
我们在一家城市教学医院的基层医疗诊所进行了一项横断面访谈研究。连续的自我认定为拉丁裔的受试者提供了知情同意书。所有受试者均使用两种酒精中毒筛查工具（CAGE问卷，即西班牙语版本的4M问卷，以及酒精使用障碍识别测试），以及用于诊断酒精滥用和依赖的标准工具——复合国际诊断访谈，以英语或西班牙语接受访谈。
在接受访谈的210名受试者中，依据标准工具诊断，36%的受试者有过酒精滥用或依赖的终生诊断。31%的受试者目前饮酒量达到有害水平。CAGE（4M）问卷得分为1分及以上时，敏感度为92%，特异度为74%；得分为2分及以上时，对于酒精滥用或依赖的终生诊断，敏感度为80%，特异度为93%。CAGE（4M）问卷得分为0、2、3和4时，其似然比分别为0.1、4.8、18.5和36.8，这使得酒精滥用或依赖诊断的验前概率（36%）到验后概率（分别为6%、73%、91%和95%）发生了显著变化。在标准临界值时，酒精使用障碍识别测试仅检测出51%的患有酒精障碍的受试者。
在基层医疗环境中的拉丁裔人群中，酒精滥用和依赖很常见，CAGE（4M）问卷是一种简短、有效的筛查酒精使用障碍的工具。
