The accuracy of the CAGE, the Brief Michigan Alcoholism Screening Test, and the Alcohol Use Disorders Identification Test in screening trauma center patients for alcoholism.
R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore 21201-1595, USA. The Journal of trauma
(Impact Factor: 2.96).
To evaluate the accuracy of questionnaire screening instruments to identify lifetime alcohol dependence among trauma center patients.
The study was conducted at a Level I trauma center between September 1994 and November 1996. Patients meeting eligibility requirements (> or = 18 years old, admission from injury scene, > or = 2 days of hospitalization, intact cognition) were evaluated for alcohol abuse and dependence. Screening instruments consisted of the CAGE, the Brief Michigan Alcoholism Screening Test, and the Alcohol Use Disorders Identification Test. Screening results were compared with lifetime alcohol dependence diagnoses made using the in-depth Psychoactive Substance Use Disorders section of the Structured Clinical Interview. Accuracy was quantified as sensitivity, specificity, positive/negative predictive values, and receiver operating characteristic curves (used to calculate area under the curve).
Of the 1,118 patients studied, lifetime alcohol dependence was diagnosed by Structured Clinical Interview in 397 (35.5%), and abuse was diagnosed in 90 (8.1%) others. The CAGE was the best predictor of lifetime alcohol dependence, i.e., had the largest area under the curve (93%) and the highest sensitivity (84%), specificity (90%), positive predictive value (82%), and negative predictive value (91%). Among patients testing positive for alcohol, 63% had a lifetime alcohol dependence diagnosis.
The CAGE is an efficient screening test to detect alcohol dependence in trauma center populations. It should be used in combination with alcohol testing to identify patients at risk of alcohol use problems.
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- "Ethanol still remains the psychoactive substance most frequently identified in the blood of divers killed in RTA (5). Among a sample of 1,118 adult patients admitted to a trauma center in Baltimore, 44% met lifetime criteria for alcohol abuse or dependence and 32% met criteria for current alcohol abuse or dependence when assessed with a structured clinical interview exam (6). Opioids are other large groups of therapeutic drugs which are abused. "
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ABSTRACT: Background: Motor vehicle collisions (MVC) comprise a majority cause of referral to the
emergency department (ED). A large proportion of MVC appear to be preventable, if more
effective measures against driving after substance abuse can be implemented.
Objective: This study was aimed to investigate the prevalence of substance abuse among
drivers of MVC, following road traffic accidents (RTA).
Materials and Methods: This case-control research was conducted from July to October
2007. One hundred MVC drivers admitted in the ED were included as the case group and
110 hospitalized patients, due to nontraumatic causes were used as controls. History of substances
abused was obtained and urine samples were tested for opium in both groups. Finally
the history and laboratory results of the groups were compared using SPSS 18.
Results: Of the 100 patients in the case group, 39 (39%) were positive for substance abuse
(100% males). On the other hand, 49 (44.5%) patients in the control group had positive history
or laboratory findings of substance abuse (73.9% male). Opioids were the most common
agent abused in both groups. There was no significant difference between two groups regarding
the prevalence of substance abuse (P = 0.92).
Conclusions: The prevalence of substance abuse is high among victims of road traffic injury
but in equal proportion to the control group. Health education and counseling is needed to
reduce substance abuse in the general population although it was not significantly related
to the cause of RTA.
- "Previous studies have shown that the CAGE may be a useful screening test for substance abuse in the TBI population. A score of 2 or more is considered a cut-off score indicating clinically significant alcohol and/or drug problems. The CAGE interviews were administrated as part of a follow-up study and were available for 88 patients. "
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ABSTRACT: To describe the functional outcome and health-related quality of life (HRQL) 10 years after moderate-to-severe traumatic brain injury (TBI).
A retrospective, population-based study of 62 survivors of working-age with moderate-to-severe TBI injured in 1995/1996, and hospitalized at the Trauma Referral Center in Eastern Norway. Functional status was measured by the Glasgow Outcome Scale-Extended (GOS-E). HRQL was assessed by the SF-36 questionnaire.
The mean current-age was 40.8 years. The frequency of epilepsy was 19% and the depression rate 31%. A majority had good recovery (48%) or moderate disability (44%). Employment rate was 58%. Functional and employment status were associated with initial injury severity in contrast to HRQL. Study patients had significantly lower scores in all SF-36 dimensions when compared with the general Norwegian population.
At 10-years follow-up, our study population is still in their most productive years and affected domains should be considered in long-term follow-up and intervention programs.
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- "The CAGE (cut down, annoyed, guilty, eye-opener) screener was used to ascertain alcohol abuse (Ewing, 1984). A score of 2 or more is considered positive for alcoholism (Soderstrom et al., 1997). Sensitivity and specificity range from 60% to 95% and 40 to 95%, respectively (Nilssen & Cone, 1994). "
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ABSTRACT: Measurements of intimate partner violence (IPV) based on acts of violence have repeatedly found substantial bilateral violence between intimates. However, the context of this violence is not well defined by acts alone. The objective of this research was to compare differences in women and men within each IPV status category (victim, perpetrator, and both) with respect to levels of battering as defined by their scores on the Women's Experience With Battering Scale (WEB), which asks gender-neutral questions about the abuse of power and control and fear in an intimate relationship. In our study, women disclosed higher levels of battering on the WEB, despite IPV status (victimization or both victimization and perpetration). In addition, female IPV victims were 5 times more likely than their male counterparts to disclose high rates of battering on the WEB. Depressive symptoms, symptoms of posttraumatic stress disorder, African American race, and IPV victimization were independently associated with higher WEB scores.
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