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 29,987 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study bears upon the respective validity of biochemical markers and questionnaires to detect alcohol abuse in a population with a high rate of alcohol-linked neurological complications. GammaGT and apoprotein AII were the most powerful of eight studied biochemical markers in detecting two-thirds of excessive drinkers. The CAGE questionnaire identified 74% of moderate drinkers and 94% of excessive drinkers with a life style and patterns of alcohol consumption different from previously tested target populations. The joint association of the CAGE questionnaire and apoprotein AII detected more than 9 out of 10 moderate or excessive drinkers defined on the basis of a quantity-frequency grid.
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PMID:Comparison of questionnaire and biochemical markers to detect alcohol abuse in a West Indian population. 193 Mar 67

Several studies have documented the common use of alcohol among medical students and the significant fraction of students (7% to 17%) who show a pattern of alcohol abuse. Many authors have pointed out the implications of physician impairment due to alcoholism, presently estimated at about 10%. We surveyed 263 junior and senior medical students, and our data support earlier surveys of the prevalence of alcohol abuse and indicate that students tend to drink less heavily and less frequently after entering medical school. The clinically proven CAGE questions used in the survey showed statistically significant associations between heavy or frequent drinking before and during medical school, but only 4.2% of respondents indicated that school officials had asked whether they had a drinking or drug abuse problem. Given these findings, we suggest the routine administration of screening instruments to medical students, using education and minimal intervention strategies with individuals at risk.
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PMID:A survey of drinking patterns during medical school. 198 34

A survey was conducted to better understand complaints of fatigue in patients previously diagnosed as having polio. Eighty-six individuals with postpolio syndrome and 20 healthy controls completed a questionnaire about their fatigue, the Beck Depression Inventory, and the CAGE questionnaire. The results showed that fatigue in postpolio syndrome usually occurred on a daily basis and increased in severity as the day progressed. Both the study group and controls described their fatigue as tiredness and a lack of energy. However, physical weakness was reported only in the postpolio group. Minimal physical exercise exacerbated fatigue in 48% of the postpolio group, whereas it diminished fatigue in 70% of the controls and in 15% of the postpolio group. Twenty-seven percent of the postpolio group and none of the controls reported mild to moderate depressive symptoms. However, depression, age, alcohol abuse, and employment status did not significantly affect the differences between groups in reported prevalence or description of chronic fatigue. Criteria to separate psychologic from organic causes of fatigue and treatment interventions are discussed.
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PMID:Fatigue in postpolio syndrome. 199 Oct 11

Alcohol is a major cause of morbidity and mortality in Britain. Consultation, questionnaires and laboratory tests may all be used to help identify alcohol abuse and thereby prevent and treat alcohol-related problems. Consultation which can identify 80% of alcohol abusers involves recording the findings of alcohol and general histories and physical examination. The accuracy of the assessment depends on the reliability of the respondent and the respondent's relations and friends, and on the skill of the investigator; however, thorough assessment is time-consuming and expensive. Questionnaires may identify up to 80% of alcoholics. They are generally based on the Michigan Alcohol Screening Test and CAGE questionnaires and are simple, rapid to complete, inexpensive and not dependent on skilled investigators; however, the principal disadvantage of using questionnaires is that a personal relationship is not developed with the subject. Finally, simple and complex laboratory tests may be used. Of the simple laboratory tests, raised GGT or MCV levels are the most useful and when these values are combined, 90% of alcoholics may be identified correctly. Complex laboratory tests may exhibit greater sensitivity and specificity and provide useful additional information; however, their restricted availability limits their widespread use. The value of each of these methods depends on the objective of the assessment. For population surveys, questionnaires are of greatest relative value and consultation and laboratory tests may be used to confirm the presence of alcohol abuse. In general practice and the hospital setting, it is imperative to include questions on alcohol intake and alcohol-related problems in all interviews with patients. Laboratory tests may be used to confirm suspected alcohol abuse and questionnaires may provide useful screening tools. Finally, in the specialist alcohol unit, consultation, questionnaires and laboratory investigations are all important for identifying alcohol abuse. In this setting, consultation is of particular importance and the alcohol history and physical examination should be recorded by a skilled investigator and the results confirmed with relatives and close friends. Questionnaires are useful as initial screening or assessment tools and computer-based systems may facilitate data collection. Simple and complex laboratory tests may be used to confirm the diagnosis and help ascertain the extent of disease. By assuming that 'all patients have alcohol-related problems until proven otherwise', and through the appropriate application of consultation, questionnaires and laboratory tests, identification of excessive alcohol consumption and the prevention of its sequelae will be facilitated.
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PMID:The relative value of consultation, questionnaires and laboratory investigation in the identification of excessive alcohol consumption. 208 52

Alcohol abuse is an important problem in Britain and is imposing increasing burdens both in general practice and in the hospital service. In the absence of previous investigations of the prevalence of intoxication and dependence in dental patients, 225 consecutive patients who attended the University of Bristol Dental Hospital were interviewed and examined: 75 attended for primary care, 75 for consultation at an oral surgery clinic, and 75 for elective minor oral surgery. A group of 50 consecutive dermatology out-patients were used as controls. All patients were breath analysed to determine blood alcohol concentrations. Dependence was assessed with the CAGE self-administered questionnaire. Eleven per cent of patients showed evidence of alcohol dependence, a similar proportion to that which has been demonstrated in the population of England and Wales overall. Dependent patients attended more often in the morning (71%) than in the afternoon (29%). Only four (1%) of all 275 patients showed evidence of blood alcohol (range 5-90 mg/100 ml): three who attended in the afternoon and one who attended at 9 am. No patient reported recent alcohol intake to allay anxiety. There were no significant differences between groups of patients with regard either to intoxication of dependence.
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PMID:Alcohol abuse in dental patients. 214 80

This study compared the use of computerized versus paper-and-pencil administration of three commonly employed alcohol screening tests--the Short Michigan Alcoholism Screening Test (SMAST-13), CAGE (an acronym for four questions to discern problem drinking), and a quantity-frequency scale. These instruments were administered to 280 adults receiving health care in three primary care clinics in south-central Wisconsin. One hundred forty patients were randomly assigned to complete these instruments on a Macintosh SE, and 140 were assigned to the paper-and-pencil versions. Patients were classified as alcoholic based on responses to the Diagnostic Interview Schedule and DSM-III criteria. Results indicated the sensitivity and specificity of these instruments were similar for the two methods of administration. The sensitivity of the SMAST-13 was 0.56 for computer administration and 0.58 for the pencil-and-paper form. The findings suggest that computer administration of these instruments is at least as effective as use of the standard pencil-and-paper method. The data show that computers can be used for direct entry of information by patients, avoiding separate coding of paper-and-pencil information into a computerized format for clinical systems that use system-wide computerization of medical information.
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PMID:Computerized administration of alcoholism screening tests in a primary care setting. 218 11

The role of alcohol in recurrences of atrial fibrillation (AF) was assessed in a consecutive series of 98 patients (75 men) aged less than 65 years. In addition to etiologic assessment using clinical and laboratory methods and echocardiography, the patients' drinking habits were evaluated by recording the amount of alcohol used during the week preceding AF, by responses to the CAGE (Cut, Annoying, Guilt, Eye; see below) questionnaire (a screening test for alcohol abuse) and by selected laboratory tests. Two groups of control subjects were studied: 98 sex- and age-matched patients admitted to the emergency ward for acute illnesses, and 50 subjects selected randomly from the local out-of-hospital population. The mean alcohol consumption among men during the study week was 186 g (median 45 g; range 0 to 2,100 g) among patients, whereas among male hospital and population control subjects it was 86 g (30 g; 0 to 1,050 g) and 94 g (35 g; 0 to 630 g), respectively. When the weekly alcohol consumption was analyzed in 3 categories (0; 1 to 210 g; greater than 210 g), there was a significant difference between AF cases and hospital control patients (p = 0.03), but not between AF cases and population control subjects. Multivariate analysis of data of AF cases and population control subjects showed that alcohol intake and a positive response to 1 or more of the CAGE questions were independently related to AF in men. Other independent risk factors were the presence of heart disease, low serum potassium and lack of sleep or experience of excess psychologic stress, or both.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Role of alcohol in recurrences of atrial fibrillation in persons less than 65 years of age. 222 Jun 18

Alcoholism is a major public health problem in Switzerland as in most Western industrialized countries. The general practitioner should be a key person in screening for alcohol abuse and dependency. Yet, the general practitioner should provide information and counselling upon the consequences of excessive alcohol consumption. In a strategy of routine screening by general practitioners, asking the patient about the quantity and the frequency of alcohol consumption, clinical examination and laboratory testing are less effective than a standardized questionnaire. Examples of questionnaires include the Michigan Alcoholism Screening Test (MAST) and the CAGE questionnaire. The rationale for systematic screening is that early pathological injuries due to excessive alcohol consumption are reversible. Yet, the prognosis seems to be more favourable where therapy begins early and the amount of psychosocial problems is limited. An early therapeutic intervention could be started as a multidisciplinary approach, targeting the patient and emphasizing the role of the patient's physician.
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PMID:[Alcoholism and the practicing physician]. 224 29

A sample of men in prison was interviewed and rated for the presence of six behaviours commonly thought to be impulsive: alcohol abuse (CAGE positive), sedative dependence, other drug abuse, pathological gambling, repeated aggression and self-harm. They were also asked to complete the EPQ and 15 questionnaires. Out of 61 men on a 'special protection, wing, 51 agreed to take part. We found that the score on the Impulsiveness scale of the 15 correlated with the number of disorders present in individuals, even when corrected for age. Pathological gambling and self-harm did not correlate with the presence of any of the other behaviours.
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PMID:Hot-headed or impulsive? 235 80

A prospective study of 518 patients admitted to the orthopedic and medical services of a community-based teaching hospital during a six-month period was performed to test the hypothesis that a short, easily administered questionnaire would improve the detection rate by physicians of alcohol abuse. The CAGE questionnaire--a mnemonic for attempts to cut back on drinking, being annoyed at criticisms about drinking, feeling guilty about drinking, and using alcohol as an eye opener--was utilized as a screening instrument. The mean corpuscular volume of red blood cells, liver transaminase levels, and the gamma-glutamyl transpeptidase level were also evaluated as screening tests. The presence or absence of alcoholism and alcohol abuse for a consecutive sample of CAGE-negative patients and all patients answering "yes" to one or more of the CAGE questions was established through the administration of the Michigan Alcoholism Screening Test, a detailed chart review, and analysis of quantity of alcohol consumed. Diagnostic criteria were those described in the Diagnostic and Statistical Manual III. The prevalence of alcohol abuse was 20 percent. The mean corpuscular volume, gamma-glutamyl transpeptidase value, and liver transaminase levels were very insensitive as screening tests. In contrast, the CAGE questionnaire had a sensitivity of 85 percent and a specificity of 89 percent. Only 63 percent of the alcoholic subjects and alcohol abusers were detected by their physicians, and in only 24 percent of these cases did a physician address the problem with the patient. The CAGE questionnaire is a simple, sensitive, and specific screening test for alcohol abusers.
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PMID:Screening for alcohol abuse using the CAGE questionnaire. 288 May 4


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