Table 1.
Screening Performance of Four Tests Used To Identify Hazardous/Harmful and Dependent Drinkers—the CAGE, MAST, AUDIT, and GGT
| Test | Cutoff Score1/Maximum Score | Hazardous/Harmful Drinkers | Dependent Drinkers | ||
|---|---|---|---|---|---|
|
|
|
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| Sensitivity2 % | Specificity3 % | Sensitivity % | Specificity % | ||
| CAGE | ≥ 2/4 | 50 | 92 | 74 | 91 |
| MAST | ≥ 5/53 | 85 | 87 | 84 | 87 |
| AUDIT | > 8/40 | 92 | 94 | 68 | 85 |
| GGT | > 40 IU/L4 | < 50 | 65 | < 50 | 85 |
The cutoff score approximates a balance between sensitivity and specificity. Scores above the cutoff are regarded as positive and those that fall below as negative. For example, a “yes” response to two of the four CAGE questions or a score of 5 out of 53 points on the MAST indicate alcohol abuse and suggest further assessment.
Sensitivity is a test’s ability to detect disease in a patient with the disease.
Specificity represents a test’s ability to rule out disease in a patient who does not have the disease.
The GGT is a biological test that measures the level of the liver enzyme gamma-glutamyl transferase (GGT) in the blood serum. A result of 40 international units per liter (IU/L) and higher is suggestive of long-term excessive alcohol consumption.