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Screening Tests

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Several hundred screening instruments are available today to aid clinicians and others in identifying patients with alcohol problems. Many of these tools are presented in the guide, Assessing Alcohol Problems: A Guide for Clinicians and Researchers,1 available from the National Institute on Alcohol Abuse and Alcoholism. (1 National Institute on Alcohol Abuse and Alcoholism. Assessing Alcohol Problems: A Guide for Clinicians and Researchers, 2d ed. NIH Pub. No. 03–3745. Washington, DC: U.S. Dept. of Health and Human Services, Public Health Service. Revised 2003, may be accessed online at http://pubs.niaaa.nih.gov/publications/AssessingAlcohol/index.htm.)

This issue of Alcohol Research & Health highlights some of the most popular screening tools for identifying hazardous or risky drinking. Two instruments in particular, the AUDIT and the CAGE, are cited throughout this issue—primarily because of their usefulness in a variety of settings and with a range of target populations. In contrast, the T-ACE is a test developed to ascertain drinking in a very specific population—pregnant women.

The AUDIT, CAGE, and T-ACE are presented here in their entirety. See the Assessing Alcohol Problems guide for a full description of these and other instruments, including their target audiences, reliability, clinical utility, research applications, and source references, as well as administrative issues such as scoring, time requirements, training required to deliver the screening tests, their costs, and copyright issues.

CAGE

 

T-ACE

C

Have you ever felt you should cut down on your drinking?

 

T

Tolerance: How many drinks does it take to make you feel high?

A

Have people annoyed you by criticizing your drinking?

 

A

Have people annoyed you by criticizing your drinking?

G

Have you ever felt bad or guilty about your drinking?

 

C

Have you ever felt you ought to cut down on your drinking?

E

Eye opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

 

E

Eye-opener: Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?


The CAGE can identify alcohol problems over the lifetime. Two positive responses are considered a positive test and indicate further assessment is warranted.

 


The T-ACE, which is based on the CAGE, is valuable for identifying a range of use, including lifetime use and prenatal use, based on the DSM–III–R criteria. A score of 2 or more is considered positive. Affirmative answers to questions A, C, or E = 1 point each. Reporting tolerance to more than two drinks (the T question) = 2 points.

Alcohol Use Disorders Identification Test

The Alcohol Use Disorders Identification Test (AUDIT) can detect alcohol problems experienced in the last year. A score of 8+ on the AUDIT generally indicates harmful or hazardous drinking. Questions 1–8 = 0, 1, 2, 3, or 4 points. Questions 9 and 10 are scored 0, 2, or 4 only.