Magruder-Habib K, Stevens H A, Alling W C
National Institute of Mental Health, Rockville, MD 20857.
J Clin Epidemiol. 1993 May;46(5):435-41. doi: 10.1016/0895-4356(93)90020-2.
A number of instruments have been developed to screen for alcoholism. With the advent of DSM-III and lay administered psychiatric diagnostic instruments, a test of the performance of these screens relative to diagnostic instruments is critical. In this paper, we document the relative effectiveness in a general medical clinic of the Michigan Alcoholism Screening Test (MAST), the Veterans Alcoholism Screening Test (VAST), and the CAGE questions in comparison to the DSM-III-R criteria for alcohol dependence as measured in the Composite International Diagnostic Interview (CIDI). All of the screens performed at acceptable levels, but the MAST and VAST tended to have higher performance characteristics. At the recommended cut points, they had higher sensitivity for lifetime alcohol dependence (VAST 95.1%, MAST 90.2%, CAGE 78.0%) as well as higher specificity (VAST 80.3%, MAST 81.7%, CAGE 76.1%). For present alcohol dependence only, at the recommended cut points the MAST and CAGE had sensitivity of 100% but specificity of 62.0 and 61.0% respectively. The VAST had sensitivity of 83.3% and specificity of 89.0%. We conclude that all three perform well relative to DSM-III-R criteria.
已经开发出多种用于筛查酒精中毒的工具。随着《精神疾病诊断与统计手册》第三版（DSM-III）以及由非专业人员实施的精神科诊断工具的出现，检验这些筛查工具相对于诊断工具的性能至关重要。在本文中，我们记录了密歇根酒精中毒筛查测试（MAST）、退伍军人酒精中毒筛查测试（VAST）和CAGE问卷在一家普通内科诊所相对于《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）中酒精依赖标准的相对有效性，该标准是通过综合国际诊断访谈（CIDI）来衡量的。所有筛查工具的表现都处于可接受水平，但MAST和VAST往往具有更高的性能特征。在推荐的切点上，它们对终生酒精依赖具有更高的敏感性（VAST为95.1%，MAST为90.2%，CAGE为78.0%）以及更高的特异性（VAST为80.3%，MAST为81.7%，CAGE为76.1%）。仅对于当前酒精依赖而言，在推荐的切点上，MAST和CAGE的敏感性为100%，但特异性分别为62.0%和61.0%。VAST的敏感性为83.3%，特异性为89.0%。我们得出结论，相对于DSM-III-R标准，这三种工具的表现都很好。
