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The Value of CAGE, CUGE, and AUDIT in Screening for Alcohol Abuse and Dependence Among College Freshmen
Author(s) -
Aertgeerts B.,
Buntinx F.,
BandeKnops J.,
Vanderrneulen C.,
Roelants M.,
Ansoms S.,
Fevery J.
Publication year - 2000
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.2000.tb04553.x
Subject(s) - audit , alcohol use disorders identification test , predictive value , receiver operating characteristic , cutoff , medicine , predictive validity , psychology , alcohol abuse , population , demography , poison control , clinical psychology , psychiatry , injury prevention , medical emergency , environmental health , physics , management , quantum mechanics , sociology , economics
Background: This study attempted to (1) determine the prevalence of alcohol problems in college freshmen, (2) assess the performance of both the CAGE and the Alcohol Use Disorders Identification Test (AUDIT) questionnaires in this population, and (3) assess the possibility of improving the CAGE and/or AUDIT. Methods: A sample of 3564 consecutive college freshmen, with a mean age of 18 years, at the Catholic University of Leuven, (Belgium) completed, during a cross‐sectional study, a questionnaire assessing drinking behavior and identifying students at risk as defined by DSM‐IV criteria. The questionnaire also included the CAGE questionnaire and the AUDIT. Calculations of sensitivity, specificity, negative predictive value, positive predictive value, likelihood ratios, and receiver operating characteristic curves for different scores of the CAGE and the AUDIT were performed, using DSM‐IV criteria as the reference standard. Results: The area under the receiver operating characteristic curve of the CAGE and the AUDIT was 0.76 and 0.85, respectively. The cutoff score of 1 for the CAGE was associated with a sensitivity of 42%, a specificity of 87%, a positive predictive value of 36%, and a negative predictive value of 90%. A score of 6 or more for the AUDIT gave a sensitivity of 80%, a specificity of 78%, a positive predictive value of 37%, and a negative predictive value of 77%. These results were related with a prevalence of 14.1% of alcohol problems. Replacing one question of the CAGE by “often driving under the influence'’resulted in the CUGE (acronym for “cut down, under influence, guilty feelings, and eye opener”), with an area under the curve of 0.96, a positive likelihood ratio of 8.7, and a negative likelihood ratio of 0.04. Conclusions: Prevalence of alcohol problems in college students is confirmed to be high. When screening for alcohol problems in a college freshmen population, one question seems extremely important. The newly constructed CUGE questionnaire may improve screening efforts in students, compared with existing questionnaires.