Richard Saitz, MD, MPH
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Saitz R.; Screening Tests for Alcohol Use Disorders. Ann Intern Med. 1999;130:779. doi: 10.7326/0003-4819-130-9-199905040-00007
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Published: Ann Intern Med. 1999;130(9):779.
TO THE EDITOR:
Steinbauer and colleagues (1) recommend the AUDIT for use in primary care. Although some researchers have reported similarly poor sensitivity of the CAGE questionnaire in women and elderly persons, others have reported excellent sensitivity in diverse populations (2-4); conflicting results are probably due in part to differences in reference standards and to scores considered to be positive test results. Therefore, Steinbauer and colleagues' accuracy findings may be a function of their methods and may not be generalizable.
Steinbauer and coworkers asked questions about consumption before the CAGE questionnaire was administered (a feature noted as a limitation of their study) and chose the standard cutoff for this questionnaire (instead of a best cutoff, as was chosen for the AUDIT). Both of these may have led to an underestimation of CAGE sensitivity. In addition, the authors did not report the sensitivity of the AUDIT for a lifetime disorder; if this sensitivity is similar to that reported in other studies, it would confirm a significant limitation—that the AUDIT misses past problems.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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