The CAGE questionnaire and the Short Michigan Alcohol Screening Test in trauma patients: comparison of their correlations with biological alcohol markers.

STUDY OBJECTIVES

To explore and compare the sex-specific correlation of two standard behavioral screening instruments, the Short Michigan Alcohol Screening Test (SMAST) and the CAGE, with a weighted scale that combines the three most commonly used biological alcohol markers (blood alcohol level, mean corpuscular volume, and gamma-glutamyltransferase level).

DESIGN

A prospective cohort study.

SETTING

Regional level I trauma center, in Seattle, Washington.

PARTICIPANTS

1980 male and 602 female patients 18 years of age or older, admitted with blunt or penetrating trauma.

MAIN RESULTS

Spearman rank correlations were used to compare the two screening measures with the weighted scale. The CAGE was found to correlate better than the SMAST with the weighted combination. Correlations for both measures were higher in women than in men. Among the individual biological alcohol markers used to construct the weighted scale, blood alcohol level was the marker that displayed the strongest correlation with both the CAGE and the SMAST.

CONCLUSION

We conclude that the CAGE questionnaire showed a higher correlation with a combination of biological alcohol markers than did the SMAST, and that the CAGE may be the questionnaire of choice for identification of alcohol problems in patients seen in trauma centers.