Study objective: To evaluate the sensitivity and specificity of severa
l alcohol screening instruments (CAGE, brief MAST, AUDIT, TWEAK, Histo
ry of Trauma Scale) and other measures (breath alcohol analyzer readin
g and reporting of drinking before the event), in an emergency departm
ent population, against international Classification of Disease, revis
ion 10 (ICD-10) criteria for harmful drinking and for alcohol dependen
ce from the Composite International Diagnostic Interview (CIDI) by gen
der, race, and injury status. Design: A probability sample of patients
was subjected to breath alcohol analysis and interviewed (N=1,330.) S
etting: University of Mississippi Medical Center. Results: Overall, th
e TWEAK and AUDIT methods were the most sensitive, identifying 84% and
81%, respectively, of patients who were positive for alcohol dependen
ce. Sensitivity was not as high for females, whites, or the noninjured
. Sensitivities for the breath alcohol analysis and self-reported drin
king were 20% and 29%, respectively. Conclusion: These data suggest th
at the effectiveness of screening instruments varies by gender, race,
and injury status and that positive breath alcohol analysis readings a
nd reporting of drinking before the event are not good indicators of a
lcohol dependence in this population.