Mental Health Nursing Practice: A Critique Of The CAGE Questionnaire

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CAGE Questionnaire Critique of Screening Instrument
Schvon Bussey
Valdosta State University
NURS 7250 Theoretical Foundations for Advanced Psychiatric/
Mental Health Nursing Practice

Abstract
This paper looks the validity and reliability of the CAGE questionnaire. The paper will look at the strengths and weakness of the CAGE questionnaire and the implication used in different research studies. CAGE Critique of Screening Instrument
The CAGE questionnaire is one of the most popular screening tools for alcoholism and was developed by John Ewing in 1984. The questionnaire consists of four basic questions regarding a person drinking habits. This questionnaire is for the use of screening for alcohol dependence only. CAGE questionnaire …show more content…

The answer of “Yes” accounts for one point and the answer of “No” accounts for zero point. The higher the score the greater suggestion of alcohol problems. If the patient scores a total of 2 points, he/she is considered clinically significant for alcoholism. (Williams, 2014). On the CAGE questionnaire, the final question regarding using alcohol as an eye-opener is considered the most important question. This question indicates that the patient is undergoing withdrawals in the mornings. The questionnaire may work better in a primary care setting versus a certain population that consists of heavy drinkers and college students. (Williams, 2014). The wording of the CAGE questionnaire could be a negative connation to patients. One of the negative aspects of the questionnaire is that words that may cause the patients to elicit false-positive responses. It is best to ask if the patient had symptoms within the last year. (Pilowsky & Wu, …show more content…

“It is reported to have a sensitivity of 93% and a specificity of 76% for the identification of excessive, i.e. problem, drinking and a sensitivity of 91% and specificity of 77% for the identification of alcoholism” (Williams, 2014). One study was done in a Belgium primary care setting. The study looked at the comparison of the CAGE questionnaire with other blood parameters that may indicate alcoholism. The questionnaire had a sensitivity range between 68% to 93% of men that were studied. However, the women did not have a high sensitivity range and did not show a correlation (Williams, 2014). The CAGE questionnaire has also been compared to other alcohol screening questionnaires: FAST (Fast Alcohol Screening Test) and AUDIT (Alcohol Use Disorders Identification Test).
A study was done in the United Kingdom with a sample size of 2185 patients and found that the CAGE questionnaire had a sensitivity of 40% and a specificity of 98% compared to the AUDIT questionnaire. This study was done in the emergency room setting, which looked at hazardous drinkers instead of alcohol dependence (Williams, 2014). Another study was done on ten primary care looking at the sensitivity and specificity of the CAGE questionnaire in regards to alcohol abuse and dependence. The results yield a sensitivity of 0.87 in inpatients and in primary care patients a 0.71 sensitivity (Pilowsky & Wu,

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