Hj. Rumpf et al., SCREENING QUESTIONNAIRES IN THE DETECTION OF HAZARDOUS ALCOHOL-CONSUMPTION IN THE GENERAL-HOSPITAL - DIRECT OR DISGUISED ASSESSMENT, Journal of studies on alcohol, 59(6), 1998, pp. 698-703
Objective. The aim of this study was to compare the validity of two di
rect screening questionnaires, the CAGE and MAST, in the detection of
hazardous alcohol consumption with a disguised assessment by using the
Trauma Scale in a poststratified general hospital sample. Method: Sur
gical and medical inpatients (N = 1,379) completed the three questionn
aires. Hazardous alcohol consumption was defined by criteria derived f
rom a World Health Organization study and assessed using self-reported
quantity and frequency. Results: The sensitivity of the Trauma Scale
was not significantly different compared to the CAGE and MAST, whereas
the direct questionnaires were higher in specificity and overall accu
racy (p < .0001). In male surgical patients the detection rate of the
Trauma Scale was higher compared to the CAGE (p < .05). Thirteen perce
nt of subjects with hazardous levels of alcohol consumption were detec
ted by the Trauma Scale only. In female surgical patients, the Trauma
Scale, when used as an additional tool, does not improve the detection
of hazardous drinkers. Conclusions: Because of the low specificity, i
ndirect assessment using a history of trauma cannot be recommended as
a screening instrument in a general hospital setting. Despite a high n
umber of false positives, the Trauma Scale may serve as an additional
tool in conjunction with direct questionnaires when high sensitivity i
s desired.