[Systematic use in hospitals of a alcohol problems detecting questionnaire. The CAGE (cut down, annoyed, guilty, eye opener) questionnaire].

OBJECTIVES

The CAGE questionnaire is considered a useful tool for detecting alcohol problems, especially in clinical populations. Its sensitivity exceeds 75% and its specificity 90%. Our objective was to assess performance of the French version of the CAGE (DETA) in identifying patients who meet the DSM-IV criteria and to discuss its usefulness in hospitals.

METHODS

Data come from study of hospital morbidity in the Auvergne district of central France in 1998. Alcohol problems were diagnosed by physicians using the DSM-IV alcohol abuse or dependency criteria. For each diagnostic category, we calculated the performance of the CAGE questionnaire at a cut-off of 2 (CAGE 2+) and of 1 (CAGE 1+).

RESULTS

The study included 5,452 patients--48.5% of them men--in acute- and intermediate-care facilities. CAGE 2+ had a sensitivity of 77% and a specificity of 94% among the diagnosed patients. It was more sensitive for patients diagnosed as alcohol-dependent than for alcohol abusers (61% vs 84%), but specificity was identical for both groups (94%). These results are similar to the properties of the English version. For a cut-off of 1 the CAGE had a sensitivity of 88% and a specificity of 87%.

CONCLUSION

The French version of CAGE is a useful screening tool for alcohol abuse and dependance. Its systematic use in hospitals is desirable: a positive response to any item should attract the physician's attention and lead to further investigation.