DEVELOPMENT OF A SCREENING QUESTIONNAIRE FOR THE GENERAL-HOSPITAL ANDGENERAL PRACTICES

The purpose of this study was to develop a sensitive as well as brief screening questionnaire by combining the well-known instruments CAGE a nd the Michigan Alcoholism Screening Test (MAST) in detecting patients with alcohol dependence or abuse in general hospitals and general pra ctices. The number of items was reduced by means of logistic regressio n and item analysis based on data of 1,167 consecutive admissions of a general hospital who completed both questionnaires. Further data were derived from a sample of 774 patients from 10 randomly selected gener al practices, A solution with nine items was validated In a second sam ple of 436 hospital inpatients. In all three samples, cases screening positive were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry to provide ICD-10 and DSM-III-R or DSM-IV diagnosis , In addition, 103 subjects with negative screening results were inter viewed in the second general hospital sample, On grounds of the data o f all three samples, a solution of seven items was chosen, This instru ment comprises two CAGE and five MAST questions (Luebeck Alcohol Depen dence and Abuse Screening Test; LAST) and was significantly higher in sensitivity than CAGE and SMAST. Data were robust in all three samples , It is concluded that the LAST is an optimized instrument for use in general hospital and general practice.