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The T-ACE is a four-item questionnaire usable in assessing pregnant women for risk drinking in a clinical practice setting. The T-ACE was developed in 1989 using data from pregnant American women.

Target Population

Adults, especially pregnant women.

Administrative Issues

4 items

Time required: 1 minute
Administered by anyone
No training required for administration


Time required: 5 minutes
Scored by administrator
No computerized scoring or interpretation available
Norms available
Normed on Black inner-city women attending antenatal clinic


Measures of validity derived:
  • Criterion (predictive, concurrent, "postdictive")
Sensitivity = 69 percent, specificity = 89 percent, positive predictive value = 23 percent, efficiency = 88 percent (Efficiency: overall percent correct)

Clinical Utility of Instrument

This is a screening device to identify pregnant women at risk for drinking amounts which may be dangerous to the fetus. Positive results indicate exploration of women's drinking.

Research Applicability

1. Can be used in conjunction with laboratory results and/or heavy drinking. 2. To estimate prevalence of pregnant women at risk.

Copyright, Cost, and Source Issues

Copyright; permission needed to publish.


S. Martier, Ob/Gyn
4707 Saint Antoine
Detroit, MI 48201

Source Reference

Sokol, R.J.; Martier, S.S.; and Ager, J.W. The T-ACE Questions: Practical prenatal detection of risk drinking. Am J Obstet Gyn 60:863-870, 1989.

Supporting References

Elliot, D.L., and Hickam, D.H. Use of the T-ACE questions to detect risk-drinking source. Am J Obstet Gyn 163(2):684-684, 1990.

Pietrantoni, M., and Knuppel, R.A. Alcohol use in pregnancy. Clinics Perinat 18(l):93-111, 1991.

Russell, M.; Czarnecki, D.M.; Cowan, R.; McPherson, E.; and Mudar, P.J. Measures of maternal alcohol use as predictors of development in early childhood. Alcoholism Clin Exp Res 15(6):991-1000, 1991.

Kemper, K.J. Self-administered questionnaire for structured psychosocial screening. Pediatrics 89(3):433-436, 1992.

Bradley, K. Interpreting Cage scores. Ann Int Med 116(12):1032-1032, 1992.

Updated: October 2000