CAGE vs quantitative assessment for detection of EtOH abuse

[DrMetal]

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Was doing a USMLE world question that basically asked: What is the most effective method of detecting alcohol abuse or dependence in this patient?

b) Inquire about the type, frequency, quantity of alcohol use
c) Administer a screening questionnaire such as CAGE.

The correct answer was c) , and the answer explanation states that screening questionnaires are superior, as demonstrated by studies (no specific reference was given in the answer explanation, so I'm not sure what study they're talking about).

Is this true? Would you really trust CAGE (especially in the form of a written questionnaire) over a solid face-to-face inquiry over the quantity/pattern of alcohol use?

I've seen quite a few patients that were CAGE 0/4 (don't feel the need to cut down, never annoyed by criticism, never guilty, never an eye-opener). But when we got down to talking numbers and frequency, it turned out they were having some 18-20 drinks/week, behaving erratically (driving buzzed), quite close to abusive lines . . . none of which would've been revealed had I stopped at CAGE.

So is answer choice CAGE really better than quantitative assessments in detecting abuse? Thoughts?

 

[dozitgetchahi]

CAGE is validated pretty well in studies, but I totally agree with what you're saying.

There are actually other questionnaires that are better validated than CAGE (names slipping my mind at the moment) that get into the kinds of details you're talking about.

 

[DrMetal]

CAGE is validated pretty well in studies, but I totally agree with what you're saying.

There are actually other questionnaires that are better validated than CAGE (names slipping my mind at the moment) that get into the kinds of details you're talking about.

Thanks for the reply. Yeah I think CAGE is a little too simplistic. Asking more detailed questions is more likely to get you better information. But, CAGE is the validated tool, so be it.