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January 1, 1988

The Effectiveness of Routine Screening Questions in the Detection of Alcoholism

JAMA. 1988;259(1):51-54. doi:10.1001/jama.1988.03720010029035

To assess the prevalence of alcoholism in an ambulatory medical clinic and to determine the effectiveness of screening questions for alcoholism, 232 new patients in a medical primary care unit were interviewed using a questionnaire that included the Michigan Alcoholism Screening Test (MAST). Based on MAST scores, 47 of 232 subjects were designated as alcoholics, yielding a prevalence of alcoholism of 20.3%. Sensitivities and specificities for alcohol-use questions were calculated using the MAST diagnosis of alcoholism. The questions "How much do you drink?" and "How often do you drink?" yielded low sensitivities of 34.0% and 46.8%, respectively. The question "Have you ever had a drinking problem?" considered alone had a high sensitivity of 70.2%; when combined with "When was your last drink?" this question had a sensitivity of 91.5%. We recommend the routine incorporation of these last two questions into the medical history in light of the high prevalence of alcoholism in this outpatient population.

(JAMA 1988;259:51-54)