Buchsbaum D G, Buchanan R G, Centor R M, Schnoll S H, Lawton M J
Medical College of Virginia, Richmond 23298.
Ann Intern Med. 1991 Nov 15;115(10):774-7. doi: 10.7326/0003-4819-115-10-774.
To assess the performance of the CAGE (acronym referring to four questions, see below) questionnaire in discriminating between medicine outpatients with and without an alcohol abuse or dependence disorder.
A cross-sectional design of a sample of consecutive patients who received both the alcohol module of the diagnostic interview schedule and the CAGE (Cut down, Annoyed, Guilty, Eye-opener) screening questionnaire.
The outpatient medical practice of an urban university teaching hospital.
All patients 18 years or older who signed a consent form approved by the university's institutional review board.
Calculation of the sensitivity, specificity, receiver operating characteristic (ROC) curve, and likelihood ratio for CAGE scores of 0 to 4.
Thirty-six percent of the sample group met criteria for a history of alcohol abuse or dependence. A CAGE score of 2 or more was associated with a sensitivity and specificity of 74% and 91%. The calculated area under the ROC curve was 0.89, whereas the likelihood ratios for CAGE scores of 0 to 4 were 0.14, 1.5, 4.5, 13, and 100, respectively. These ratios were associated with posterior probabilities for an abuse or dependence disorder of 7%, 46%, 72%, 88%, and 98%, respectively.
Clinicians can improve their ability to estimate a patient's risk for an alcohol abuse or dependence disorder using likelihood ratios for CAGE scores.
评估CAGE问卷（该首字母缩写指代四个问题，见下文）在区分有或无酒精滥用或依赖障碍的内科门诊患者方面的表现。
对连续接受诊断访谈日程中的酒精模块和CAGE（减少饮酒量、易激惹、有负罪感、晨饮）筛查问卷的患者样本进行横断面设计。
一所城市大学教学医院的门诊医疗科室。
所有18岁及以上签署了大学机构审查委员会批准的同意书的患者。
计算CAGE评分为0至4分时的敏感性、特异性、受试者工作特征（ROC）曲线和似然比。
样本组中36%的患者符合酒精滥用或依赖史标准。CAGE评分为2分及以上时，敏感性和特异性分别为74%和91%。计算得出的ROC曲线下面积为0.89，而CAGE评分为0至4分时的似然比分别为0.14、1.5、4.5、13和100。这些似然比分别对应滥用或依赖障碍的后验概率为7%、46%、72%、88%和98%。
临床医生可以通过使用CAGE评分的似然比来提高其评估患者酒精滥用或依赖障碍风险的能力。
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