Use of the CAGE questionnaire for detecting alcohol use disorders in the emergency room

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Alcoholism is seldom detected among emergency room outpatients, which is attributed to the non-adoption of diagnostic routines, to the difficulty of doing a special anamnesis for diagnosing alcoholism, and to the lack of sensitivity and specificity of the laboratory tests. This study has the purpose to determine whether the CAGE assay (composed by 4 questions of easy memorization) is able to supply this difficulty in detecting alcoholism. We did a transversal study with consecutive sampling among outpatients of the Internal Medicine Department at Cajuru University Hospital emergency room. They were submitted to a standardized interview constituted by the CAGE and the CIDI assays (Composite International Diagnostic Interview, "demographics" and "disorders resulting from the use of alcohol" sections). From the sample obtained (n=374), we correlated the prevalence of alcoholism according to both questionnaires, considering the CIDI (DSM-IV criteria) to be the gold standard. The prevalence of alcohol dependence according to the DSM-IV criteria was 15.77%. We verified that the CAGE has 84.74% of sensitivity and 73.33% of specificity, with a cut point of 2 positive responses. We concluded that the CAGE is an instrument of easy application and good sensitivity and specificity when used at the emergency room, being able to supply the difficulties of alcoholism detection. We suggest that the CAGE be adapted as a routine at emergency rooms, increasing the alcoholism detection rate.