Asking about quantity and frequency of alcohol consumption before asking the CAGE questions produces lower ratings on the CAGE test.

BACKGROUND

We tested whether asking about alcohol consumption before asking the CAGE questions modified the answers to the CAGE test.

METHODS

Randomized trial on a smoking cessation website, in English, in 2003. Half the participants began by answering questions on quantity and frequency of alcohol consumption and then, on a second web page, answered the CAGE questionnaire (format A). The other half answered first the CAGE and then questions on quantity and frequency (format B).

RESULTS

The survey was answered by 1213 people. Fewer people gave positive answers to three of the four CAGE questions in format A than in format B. Cut-down, 32% versus 38% (P= 0.01); annoyed, 13% versus 18% (P = 0.02); eye-opener, 5% versus 8% (P = 0.02). Fewer people had a CAGE score >/=2, indicating possible alcoholism, in format A than in format B (26% versus 32%, P = 0.04). This effect was stronger in men (CAGE > or = 2, format A, 29%; format B, 39%; P = 0.03), and it was not statistically significant in women (CAGE > or = 2, format A, 25%; format B, 28%; P = 0.4).

CONCLUSION

In an internet survey, asking questions about the quantity and frequency of alcohol consumption before asking the CAGE questionnaire produced fewer positive answers to the CAGE. This effect was observed only in men.