Soderstrom C A, Smith G S, Kufera J A, Dischinger P C, Hebel J R, McDuff D R, Gorelick D A, Ho S M, Kerns T J, Read K M
R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore 21201-1595, USA.
J Trauma. 1997 Dec;43(6):962-9. doi: 10.1097/00005373-199712000-00017.
To evaluate the accuracy of questionnaire screening instruments to identify lifetime alcohol dependence among trauma center patients.
The study was conducted at a Level I trauma center between September 1994 and November 1996. Patients meeting eligibility requirements (> or = 18 years old, admission from injury scene, > or = 2 days of hospitalization, intact cognition) were evaluated for alcohol abuse and dependence. Screening instruments consisted of the CAGE, the Brief Michigan Alcoholism Screening Test, and the Alcohol Use Disorders Identification Test. Screening results were compared with lifetime alcohol dependence diagnoses made using the in-depth Psychoactive Substance Use Disorders section of the Structured Clinical Interview. Accuracy was quantified as sensitivity, specificity, positive/negative predictive values, and receiver operating characteristic curves (used to calculate area under the curve).
Of the 1,118 patients studied, lifetime alcohol dependence was diagnosed by Structured Clinical Interview in 397 (35.5%), and abuse was diagnosed in 90 (8.1%) others. The CAGE was the best predictor of lifetime alcohol dependence, i.e., had the largest area under the curve (93%) and the highest sensitivity (84%), specificity (90%), positive predictive value (82%), and negative predictive value (91%). Among patients testing positive for alcohol, 63% had a lifetime alcohol dependence diagnosis.
The CAGE is an efficient screening test to detect alcohol dependence in trauma center populations. It should be used in combination with alcohol testing to identify patients at risk of alcohol use problems.
评估问卷筛查工具在识别创伤中心患者终生酒精依赖方面的准确性。
该研究于1994年9月至1996年11月在一级创伤中心进行。对符合入选标准（年龄≥18岁，从受伤现场入院，住院≥2天，认知功能完好）的患者进行酒精滥用和依赖评估。筛查工具包括CAGE问卷、密歇根酒精ism筛查简表和酒精使用障碍识别测试。将筛查结果与使用结构化临床访谈中深入的精神活性物质使用障碍部分做出的终生酒精依赖诊断进行比较。准确性通过敏感性、特异性、阳性/阴性预测值以及受试者工作特征曲线（用于计算曲线下面积）进行量化。
在1118名研究患者中，通过结构化临床访谈诊断出397名（35.5%）有终生酒精依赖，另外90名（8.1%）被诊断为滥用。CAGE问卷是终生酒精依赖的最佳预测工具，即曲线下面积最大（93%），敏感性最高（84%），特异性（90%）、阳性预测值（82%）和阴性预测值（91%）也最高。在酒精检测呈阳性的患者中，63%被诊断为有终生酒精依赖。
CAGE问卷是检测创伤中心人群酒精依赖的有效筛查测试。它应与酒精检测结合使用，以识别有酒精使用问题风险的患者。
