SCREENING QUESTIONNAIRES IN THE DETECTION OF HAZARDOUS ALCOHOL-CONSUMPTION IN THE GENERAL-HOSPITAL - DIRECT OR DISGUISED ASSESSMENT

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.