Study to Establish a correlation between CAGE and AUDIT scoring systems in identifying Alcohol use Disorder

Abstract

Background: Alcohol use disorder (AUD) or alcohol dependence syndrome, more commonly known as alcoholism, is a major health problem in India and a term used to describe problems arising from alcohol consumption. Alcohol-related health problems are global public health issues that continue to go unrectified. Alcohol use disorder identification test (AUDIT), a short comprehensive questionnaire dedicated to identify at risk individuals and stratify patients based on their test scores into various probable diagnosis of hazardous use, harmful use, and alcohol dependence respectively. CAGE questionnaire is a set of 4 questions used alone or in conjunction with AUDIT to identify individuals with problem drinking. Score for CAGE is based on yes or no response to the above 4 questions, where 2 or more identify an individual with problem drinking.

Objectives: Evaluating incidence of Alcohol use disorder, while comparing AUDIT and CAGE as screening questionnaire in identifying alcohol use disorder.

Methods: An observational study conducted in the confines of a tertiary care hospital, participants were subjected to the AUDIT and CAGE questionnaire. Area under the receiver operating characteristic (AUROC) was calculated to determine sensitivity and specificity of CAGE in comparison to AUDIT.

Results: Of the 110 participants, 104 were male and rest female. Incidence of alcohol use disorder 85%, the sensitivity of CAGE was found to be 63.83% while specificity was 93.75%. CAGE was inferior to AUDIT in identifying mild alcohol abuse and was on par with AUDIT in diagnosing alcohol dependence.

Conclusion: We conclude that AUD is a major lifestyle choice plaguing a significant portion of the healthcare system, moderation is key and abstinence the best way to avoid all complications that are associated with alcohol abuse.

AUDIT questionnaire is best when screening individuals with suspected AUD, since it better identifies alcohol abuse in its mild stages and this better prepares the treating physician regarding holistic care and preventing the patient from developing alcohol use disorder.