The value of the CAGE in screening for alcohol abuse and alcohol dependence in general clinical populations: a diagnostic meta-analysis
The value of the CAGE in screening for alcohol abuse and alcohol dependence in general clinical populations: a diagnostic meta-analysis
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DOI：
10.1016/s0895-4356(03)00254-3
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发表时间：
2004-01-01
影响因子：
7.2
通讯作者：
Kester, A
中科院分区：
文献类型：
--
作者：
Aertgeerts, B;Buntinx, F;Kester, A
目的：通过Meta分析评价CAGE在一般临床人群酒精滥用或依赖筛查中的诊断特点，并测试一种新的合并ROC曲线的方法。方法：对1974年1月1日至2001年12月31日期间进行的Medline检索。测量：诊断价值的计算。结果：我们以DSM标准为金标准确定了35篇文章，以检验CAGE的诊断价值。只有10项研究可以纳入荟萃分析。当截断点大于或等于2时，住院患者的合并敏感度(0.87)远远好于初级保健患者(0.71)或门诊患者(0.60)。每一组的汇集特异性也不同。在人群中，似然比似乎相对恒定(总体LR+：3.44；LR-：0.18)。我们计算的合并AUC为0.87(95%可信区间为0.85-0.89)。在低特异值时，敏感度在研究中是同质的，而在低敏感度时，特异度是不同的。结论：在推荐的筛查切点大于或等于2的情况下，使用该试验对CAGE的诊断价值有限。(C)2004 Elsevier Inc.保留所有权利。
Objective: To perform a meta-analysis to assess diagnostic characteristics of the CAGE in screening for alcohol abuse or dependence in a general clinical population and to test a new method for pooling of ROC curves.Methods: Medline search performed over the period 1/1/1974 to 31/12/2001.Measurement: Calculation of diagnostic values.Results: We identified 35 articles using the DSM criteria as the gold standard to test the diagnostic value of the CAGE. Only 10 studies could be included for the meta-analysis. With a cutoff point greater than or equal to2, the pooled sensitivity is far better in inpatients (0.87) than in primary care patients (0.71) or ambulatory patients (0.60). The pooled specificity also differs for each group. The likelihood ratios seem to be relatively constant over the populations (overall LR+:3.44;LR-:0.18). We calculated a pooled AUC of 0.87 (95% CI 0.85-0.89). At low specificity values, the sensitivity was homogenous over the studies, and at a low sensitivity, the specificity was heterogenous.Conclusion: The diagnostic value of the CAGE is of limited value using this test for screening purposes at his recommended cutpoint of greater than or equal to2. (C) 2004 Elsevier Inc. All rights reserved.