Cherpitel C J
Western Consortium for Public Health, Alcohol Research Group, Berkeley, California 94709, USA.
J Stud Alcohol. 1995 Nov;56(6):695-700. doi: 10.15288/jsa.1995.56.695.
The purpose of this study is to evaluate the performance of a number of alcohol screening instruments (CAGE, Brief MAST, AUDIT, TWEAK), in an emergency room population, against ICD-10 criteria for harmful drinking and for alcohol dependence from the CIDI, by gender, race and injury status.
A probability sample of patients were interviewed (N = 1,330) at the University of Mississippi Medical Center. Analyses were carried out on only current drinkers (n = 771; 58% of the sample). Instruments were compared on sensitivity, specificity and area under the curve using receiver operating characteristic (ROC) analysis to determine optimum cut points.
Overall the TWEAK and AUDIT performed best (in relation to sensitivity and area under the ROC curve) at standard cut points (3 and 8, respectively) for both harmful drinking and alcohol dependence. These instruments did not perform equally well across all subgroups, however, particularly among women, and among whites where the CAGE, with a cut point of 1, outperformed both the TWEAK and AUDIT at standard cut points. The TWEAK at a cut point of 2 also did as well as the CAGE at a cut point of 1 among women.
These data suggest that standard screening instruments do not perform equally well across ethnic and gender subgroups and that consideration of alternative cut points may be appropriate in some populations.
本研究旨在评估多种酒精筛查工具（CAGE、简易MAST、AUDIT、TWEAK）在急诊室人群中，根据性别、种族和损伤状况，对照国际疾病分类第十版（ICD - 10）中关于有害饮酒和酒精依赖的标准（来自复合国际诊断访谈表（CIDI））的表现。
在密西西比大学医学中心对患者进行概率抽样访谈（N = 1330）。仅对当前饮酒者（n = 771；占样本的58%）进行分析。使用受试者工作特征（ROC）分析比较各工具在敏感性、特异性和曲线下面积方面的表现，以确定最佳切点。
总体而言，对于有害饮酒和酒精依赖，TWEAK和AUDIT在标准切点（分别为3和8）时表现最佳（在敏感性和ROC曲线下面积方面）。然而，这些工具在所有亚组中的表现并不相同，特别是在女性以及白人中，CAGE切点为1时，在标准切点上优于TWEAK和AUDIT。在女性中，TWEAK切点为2时的表现与CAGE切点为1时相当。
这些数据表明，标准筛查工具在不同种族和性别亚组中的表现并不相同，在某些人群中可能需要考虑使用替代切点。
