Escobar F, Espí F, Canteras M
Zone IV Health Centre, Albacete, Spain.
Drug Alcohol Depend. 1995 Dec;40(2):151-8. doi: 10.1016/0376-8716(95)01200-1.
Alcoholism is an uncommon diagnosis in normal medical activity despite being a prevalent health problem in Spain. One of the main obstacles that make diagnosis difficult is the lack of valid, reliable instruments of detection. The aim of the present study is to validate different tests for diagnosing alcoholism (CAGE, Alcohol Clinical Index, MCV, GGT, GOT/GPT and GGT/AP) in primary care and compare their diagnostic efficacy.
The diagnostic efficacy and discriminating power of each of the tests were calculated from the results obtained from 219 patients (out of 698 aged over 15 years) who answered the CAGE questionnaire. Patients were selected from doctors surgeries in an urban health centre. The diagnosis of alcoholism was based on the presence of DSM-III criteria and/or a daily alcohol consumption of 60 grams or more in men and 30 or more in women.
The CAGE questionnaire showed a sensitivity of 69.86% and specificity of 80.46%, with the cut-off point at 1. The remaining tests showed a poorer diagnostic efficacy. The CAGE questionnaire scoring was the parameter that best distinguished alcoholic patients from non-alcoholic patients.
The CAGE questionnaire demonstrates the greatest efficacy and discriminating power for diagnosing patients with alcoholism in primary care.
尽管酗酒在西班牙是一个普遍存在的健康问题，但在正常医疗活动中它却是一种不常见的诊断。导致诊断困难的主要障碍之一是缺乏有效、可靠的检测工具。本研究的目的是验证在初级保健中用于诊断酗酒的不同测试（CAGE问卷、酒精临床指数、平均红细胞体积、γ-谷氨酰转肽酶、谷草转氨酶/谷丙转氨酶和γ-谷氨酰转肽酶/碱性磷酸酶），并比较它们的诊断效能。
根据对219名（在698名15岁以上患者中）回答了CAGE问卷的患者所获得的结果，计算每个测试的诊断效能和鉴别能力。这些患者是从一个城市健康中心的医生诊所中挑选出来的。酗酒的诊断基于符合《精神疾病诊断与统计手册》第三版标准和/或男性每日酒精摄入量60克或更多、女性30克或更多。
CAGE问卷显示敏感性为69.86%，特异性为80.46%，临界值为1。其余测试显示出较差的诊断效能。CAGE问卷评分是区分酗酒患者和非酗酒患者的最佳参数。
CAGE问卷在初级保健中诊断酗酒患者时显示出最大的效能和鉴别能力。
