Cyr M G, Wartman S A
Division of General Internal Medicine, Rhode Island Hospital, Providence 02902.
JAMA. 1988 Jan 1;259(1):51-4.
To assess the prevalence of alcoholism in an ambulatory medical clinic and to determine the effectiveness of screening questions for alcoholism, 232 new patients in a medical primary care unit were interviewed using a questionnaire that included the Michigan Alcoholism Screening Test (MAST). Based on MAST scores, 47 of 232 subjects were designated as alcoholics, yielding a prevalence of alcoholism of 20.3%. Sensitivities and specificities for alcohol-use questions were calculated using the MAST diagnosis of alcoholism. The questions "How much do you drink?" and "How often do you drink?" yielded low sensitivities of 34.0% and 46.8%, respectively. The question "Have you ever had a drinking problem?" considered alone had a high sensitivity of 70.2%; when combined with "When was your last drink?" this question had a sensitivity of 91.5%. We recommend the routine incorporation of these last two questions into the medical history in light of the high prevalence of alcoholism in this outpatient population.
为评估一家门诊医疗诊所中酒精成瘾的患病率，并确定酒精成瘾筛查问题的有效性，我们使用一份包含密歇根酒精成瘾筛查测试（MAST）的问卷，对一家初级医疗护理单元的232名新患者进行了访谈。根据MAST评分，232名受试者中有47名被认定为酒精成瘾者，酒精成瘾的患病率为20.3%。使用MAST对酒精成瘾的诊断结果计算了酒精使用问题的敏感度和特异度。“你喝多少酒？”和“你多久喝一次酒？”这两个问题的敏感度分别较低，为34.0%和46.8%。单独来看，“你是否曾有饮酒问题？”这个问题的敏感度较高，为70.2%；当与“你最后一次喝酒是什么时候？”结合时，这个问题的敏感度为91.5%。鉴于该门诊人群中酒精成瘾的高患病率，我们建议将最后这两个问题常规纳入病史询问中。
