Steinweg Donald Lee, Worth Heidi
From the Department of Medicine, Walter Reed Army Medical Center, Washington, D.C. USA; From the Uniformed Services University of the Health Sciences, Washington, D.C. USA.
From the Uniformed Services University of the Health Sciences, Washington, D.C. USA.
Am J Med. 1993 May;94(5):520-523. doi: 10.1016/0002-9343(93)90088-7.
To compare the efficiency of screening for alcoholism using two different introductions to the CAGE questions.
Forty-three alcoholics on inpatient medical and surgical services were identified through random distribution of the Michigan Alcoholism Screening Test.
Participants were randomized to two groups receiving different introductions to the CAGE questions. Group I was introduced by a simple open-ended question. Group II patients were asked first to quantitate the volume and frequency of their drinking. The outcome measures were the scores on the four CAGE questions recorded by an independent observer.
Eighteen of 21 (86%) patients in Group I admitted to prior attempts to cut back on their drinking as compared with 8 of 22 (36%) in Group II (p = 0.002). Likewise 10 of 21 (49%) patients in the first group admitted to annoyance compared with just 3 of 22 (14%) in Group II. The average scores per patient in the two groups were significantly different: Group I = 2.52 versus Group II = 1.23 (p = 0.0002). Using a screening CAGE score of two or more to identify an alcoholic patient, the open-ended introduction identified 95% of the alcoholics compared with only 32% when the closed-ended introduction was used (p < 0.0001).
Our study demonstrates that the sensitivity of the CAGE questionnaire in screening for alcoholism is dramatically enhanced by an open-ended introduction. In contrast, the sensitivity of these questions is greatly reduced when preceded by inquiries that seek to define the quantity and frequency of drinking.
比较使用两种不同的方式引入CAGE问题来筛查酒精中毒的效率。
通过随机发放密歇根酒精中毒筛查测试，确定了43名在内科和外科住院服务的酒精中毒患者。
参与者被随机分为两组，接受不同方式引入的CAGE问题。第一组通过一个简单的开放式问题引入。第二组患者首先被要求对饮酒量和频率进行量化。结果指标是由独立观察者记录的四个CAGE问题的得分。
第一组21名患者中有18名（86%）承认之前曾试图减少饮酒量，而第二组22名患者中只有8名（36%）（p = 0.002）。同样，第一组21名患者中有10名（49%）承认有烦恼，而第二组22名患者中只有3名（14%）。两组患者的平均得分有显著差异：第一组 = 2.52，第二组 = 1.23（p = 0.0002）。使用CAGE筛查分数为两分或更高来识别酒精中毒患者时，开放式引入方式识别出了95%的酒精中毒患者，而使用封闭式引入方式时仅识别出32%（p < 0.0001）。
我们的研究表明，通过开放式引入，CAGE问卷在筛查酒精中毒时的敏感性显著提高。相比之下，在询问饮酒量和频率之前提出这些问题时，其敏感性会大大降低。
