USING THE CAGE TO SCREEN FOR DRINKING-RELATED PROBLEMS IN COLLEGE-STUDENTS

Objective: As a brief alcohol screening instrument the CAGE has demonstrated a high degree of accuracy in identifying problem drinkers among adults. However, some studies have questioned its screening accuracy within a college population. The research presented in this article contains the results of two additional studies that examined the ability of the CAGE to identify problem drinkers within a college student population. Method: In both 1988 and 1992 a questionnaire of various drinking practices, including CAGE items, was mailed to a random sample of 1,000 students at a large midwestern university (response rate: 58.2%, 1988; 49.8%, 1992). Using identical problem-drinking criteria, sensitivity, specificity and positive predictive values at various cutoff scores of the CAGE were calculated for both sets of data and for gender. Results: At the recommended CAGE cutoff score of >2 for a positive test the sensitivity and positive predictive values (PPV) were slightly higher for the 1992 sample. The PPV values at that cutoff score were 46% (1988) and 49% (1992) and 48% for the combined data. In both samples the screening values were lower for women. Conclusions: These data from both surveys do not support the CAGE as a screening measure for problem drinking with this population. It appeared to be less accurate with women although that conclusion should be tempered by the fact that there was a relatively low percentage of problem drinkers found among women.