Russell M, Martier S S, Sokol R J, Mudar P, Jacobson S, Jacobson J
Research Institute on Addictions, Buffalo, NY 14203, USA.
Am J Public Health. 1996 Oct;86(10):1435-9. doi: 10.2105/ajph.86.10.1435.
This study investigated the efficacy of screening for risk drinking during pregnancy with two brief questionnaires, TWEAK and T-ACE. Both include an assessment of tolerance based on the number of drinks women report they can hold.
Subjects were disadvantaged African-American obstetric patients in Detroit, Mich. Traditional alcoholism screens (Michigan Alcohol Screening Test [MAST], CAGE) and the tolerance question were administered (n = 2717); TWEAK and T-ACE were constructed from tolerance and embedded MAST and CAGE items. In a separate sample (n = 1420), only the T-ACE was administered. Periconceptional risk drinking was the gold standard. Screen evaluations were based on receiver-operating characteristic analyses.
At the cutpoint of 2, sensitivity/specificity for embedded screens were 91/77 for TWEAK and 88/79 for T-ACE; comparable values for T-ACE alone were 67/86. TWEAK and T-ACE screened more effectively than CAGE or MAST.
Embedded versions of TWEAK and T-ACE were both highly sensitive to periconceptional risk drinking in this population. Administering T-ACE alone reduced its sensitivity; this suggests that MAST and CAGE administration improves its performance.
本研究调查了使用两种简短问卷（TWEAK和T-ACE）筛查孕期风险饮酒的有效性。这两种问卷都包括根据女性报告的能承受的饮酒量来评估耐受性。
研究对象是密歇根州底特律市处于不利地位的非裔美国产科患者。采用了传统的酒精中毒筛查方法（密歇根酒精筛查测试[MAST]、CAGE）并询问了耐受性问题（n = 2717）；TWEAK和T-ACE由耐受性以及嵌入的MAST和CAGE项目构建而成。在另一个样本（n = 1420）中，仅使用了T-ACE。受孕前风险饮酒是金标准。筛查评估基于受试者工作特征分析。
在临界值为2时，嵌入式筛查中TWEAK的敏感性/特异性为91/77，T-ACE为88/79；单独使用T-ACE时的相应值为67/86。TWEAK和T-ACE的筛查效果比CAGE或MAST更好。
在该人群中，嵌入式的TWEAK和T-ACE对受孕前风险饮酒均高度敏感。单独使用T-ACE会降低其敏感性；这表明同时使用MAST和CAGE可提高其性能。
