COMPARISON OF CAGE AND MAST WITH THE ALCOHOL MARKERS CDT, GAMMA-GT, ALAT, ASAT AND MCV

Many alcoholics deny abuse. To screen greater samples for alcohol depe ndence, short questionnaires, e.g; the CAGE or MAST are often applied. Frequently laboratory parameters [i.e. 'alcohol markers', such as car bohydrate-deficient transferrin (CDT), gamma-glutamyl transferase or m ean corpuscular volume of erythrocytes] are used to support the diagno sis of long-standings heavy alcohol consumption. in this study, the se lf-ratings (CAGE and MAST) were compared with the above laboratory par ameters in an unselected sample of 204 patients admitted to a general hospital. The sensitivities, specificities. and positive (PPV) as well as negative predictive values of the CAGE, the MAST, and the alcohol markers were calculated along with the reported alcohol consumption or the ICD-10 diagnosis as standard. According to recent harmful alcohol consumption levels (women >225 g/week: men >350 g/week), the sensitiv ities and the PPVs were rather low in all tests (sensitivity <60%: PPV <50%). With the ICD-10 diagnosis as standard, the CAGE and MAST showe d a rather high specificity (>95%) and PPV (about 90%). CDT revealed t he best PPV of all alcohol markers (60%). However, the sensitivity of the CAGE, MAST, and the alcohol markers for the ICD-10 diagnosis was r ather poor (<60%). This low sensitivity impedes the usefulness of thes e questionnaires and alcohol markers as screening tests for alcoholism in general hospitals.