The CAGE Questionnaire for Alcohol Misuse: A Review of Reliability and Validity Studies

Abstract

Purpose: To review the reliability and validity of the CAGE questionnaire across different patient populations and discuss its role in the detection of alcohol-related problems. Methods: The Cochrane Database for Systematic Reviews, Medline, Embase, and Psychinfo were searched. No systematic reviews were found on the Cochrane Database. Search of the other databases yielded one systematic review and one meta-analysis, on different aspects of CAGE. Three articles on reliability and 16 on validity of CAGE were found and used. Studies generally yielded Level II evidence. Results: CAGE has demonstrated high test-retest reliability (0.80-0.95), and adequate correlations (0.48-0.70) with other screening instruments. The questionnaire is a valid tool for detecting alcohol abuse and dependence in medical and surgical inpatients, ambulatory medical patients, and psychiatric inpatients (average sensitivity 0.71, specificity 0.90). Its performance in primary care patients has been varied, while it has not performed well in white women, prenatal women, and college students. Furthermore, it is not an appropriate screening test for less severe forms of drinking. Conclusions: CAGE is short, feasible to use, and easily applied in clinical practice. However, users should be aware of its limitations when interpreting the results. A positive screen should be followed by a proper diagnostic evaluation using standard clinical criteria.

Depression, Anxiety and Alcohol Abuse in a Gastroenterology Intensive Care Unit: Prevalence and Detection

“…CAGE scores were significantly higher in men, as expected. The sensitivity of the CAGE test (52%) was lower in this sample than the expected value of 71%; however, the specificity (95%) was higher than the expected value of 90% [19]. The high cut-offs used for standard intake levels (40g for females and 80g for males) may explain these differences.…”

Cribaje de trastornos por uso de alcohol en pacientes psiquiátricos ambulatorios: influencia de género, edad, y diagnóstico psiquiátrico

“…En la prueba diagnóstica, el punto de corte es un tema crítico, dado que afecta la sensibilidad y especificidad de la prueba. En general, la estimación de sensibilidad y especificidad del cuestionario CAGE es de 71% y 90%, respectivamente, para las poblaciones clínicas (Dhalla y Kopec, 2007;Mitchell et al, 2014). En pacientes con esquizofrenia, el punto de corte de 1 o más muestra una sensibilidad de 91% y una especificidad de 83% (Dervaux et al, 2006), con variaciones hasta 82% y 94%, respectivamente, con un punto de corte de 2.…”

“…Tiene estimaciones de sensibilidad de 71% y especificidad de 90% para poblaciones clínicas (Dhalla y Kopec, 2007;Mitchell et al, 2014). Ha sido validado en varios idiomas, incluyendo castellano (Rodríguez-Martos, 1986).…”

Pattern of Peripheral Neuropathy Among Patients With Alcohol Dependence Syndrome

“…Developed by Ewing in 1968, the screening test has 4 items, and a score greater than 2 is considered clinically significant. [9,10] The amount of alcohol consumption could correlate with the severity of neuropathy. The total life time dose of ethanol (TLDE) expressed in kg of ethanol per kg of body weight, was utilized to identify the same.…”