THE UTILITY OF THE BRIEF MAST AND THE CAGE IN IDENTIFYING ALCOHOL-PROBLEMS - RESULTS FROM NATIONAL HIGH-RISK AND COMMUNITY SAMPLES

Background: The CAGE and the Brief MAST questionnaires are widely used to screen for alcohol problems. We tested the performance of these in struments in 2 population-based groups: a high-risk sample composed of relatives of alcoholic subjects and a community sample consisting of families not selected for alcoholism tie, alcohol dependence disorder) . Methods: A total of 3435 relatives of alcoholics and 795 control sub jects were interviewed with the Semi-Structured Assessment for the Gen erics of Alcoholism (SSAGA) semistructured interview in a multicenter collaborative study on the genetics of alcoholism. The performance of ''CAGE'' and ''Brief MAST'' equivalent items in the SSAGA was characte rized by their positive predictive value, sensitivity, specificity, an d percentage of the sample who screened positive. Results: Both questi onnaires performed well in the highrisk sample, where the base rate of alcoholism was 35%. However, in the community sample, where the 16% r ate of alcoholism was comparable to that of the US population (14%),an acceptable positive predictive value could be achieved only through a substantial reduction in sensitivity. Results were similar when men w ere compared with women and when lifetime alcoholics were compared wit h current alcoholics. Conclusion: The ''Brief MAST'' and ''CAGE'' can be effective instruments to screen for significant alcohol problems in both community and high-risk patients; as expected, their positive pr edictive value increases with the base rate of alcoholism in the popul ation being screened.