Schorling J B, Willems J P, Klas P T
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908.
Am J Med. 1995 Mar;98(3):232-6. doi: 10.1016/S0002-9343(99)80368-4.
The two-question drinking test ("Have you ever had a drinking problem?" and "When was your last drink?") is frequently cited as an accurate method of screening for alcoholism, yet its performance has never been validated. This study evaluated its utility among patients in two primary care settings.
The two-question drinking test was compared to the Michigan Alcohol Screening Test (MAST) as the standard criterion for the diagnosis of alcoholism. The subjects were 334 nonpregnant English-speaking patients over the age of 18 seen in two university outpatient teaching clinics.
The overall prevalence of alcoholism based on a MAST score > or = 5 was 18%. The sensitivity of the two-question test was 53% and its specificity 93%. The question "When was your last drink?" added little to the question "Have you ever had a drinking problem?" The latter question alone had a sensitivity of 50% and a specificity of 97%.
The two-question test is not sensitive enough to be used to screen for alcohol abuse among outpatients. However, because of the low false positive rate, a positive response to the question "Have you ever had a drinking problem?" may help identify alcoholic patients.
两问题饮酒测试（“你是否曾有饮酒问题？”以及“你最后一次饮酒是什么时候？”）常被视为一种准确的酒精中毒筛查方法，但其效果从未得到验证。本研究评估了该测试在两个基层医疗环境中对患者的实用性。
将两问题饮酒测试与密歇根酒精筛查测试（MAST）相比较，后者作为酒精中毒诊断的标准准则。研究对象为在两家大学门诊教学诊所就诊的334名年龄超过18岁、非孕期且讲英语的患者。
基于MAST评分≥5的酒精中毒总体患病率为18%。两问题测试的敏感性为53%，特异性为93%。“你最后一次饮酒是什么时候？”这个问题相比“你是否曾有饮酒问题？”增加的信息量很少。仅后一个问题的敏感性为50%，特异性为97%。
两问题测试的敏感性不足以用于门诊患者酒精滥用的筛查。然而，由于假阳性率较低，对“你是否曾有饮酒问题？”这个问题的肯定回答可能有助于识别酒精中毒患者。
