The CAGE screening tool is a four-question test intended to evaluate the test-taker’s relative risk of having an alcohol use disorder (AUD). “CAGE” is an acronym that corresponds to keywords in each of the test’s four standard questions (cut-annoyed-guilty-eye).1
Since its introduction in the 1970s, CAGE has been widely adapted for a variety of more specific purposes, most notably for screening drug use disorders or as a more comprehensive diagnostic tool. Classic CAGE is a screening tool meant for facilitating triage and is not intended for diagnostics.2
Though it can be administered by a trained clinician, CAGE is specifically designed to be self-administered by a layperson. Answering all four questions takes less than one minute and the standard test is considered to be reliable. In its intended role, the CAGE test has proven to be credible, even today.2
But given that it’s five decades old, why is it still so popular? It comes down to its blend of simplicity and accuracy.2 Here we’ll explore why CAGE continues to endure, especially in its intended purpose.
Most CAGE questionnaires have the following four questions or variations of the same.1,2
Each CAGE question can be answered as “yes” or “no” and is worth one point. In most versions, two “yeses” minimum for males and one “yes” for females indicate a higher chance of AUD, warranting full diagnostics facilitated by a qualified psychiatrist. This minimum threshold may vary depending on the facilitator or specific AUD treatment program. Tests have to be completed to be considered valid.1,2
CAGE is meant for laypersons who want to know whether they or someone they know should seek medical attention. Though it lacks the granularity and detail of other AUD screening tests, it is easy to remember, can be answered quickly, and can be performed on oneself or others. The CAGE test could also be performed by clinicians as a pre-screening method before a full diagnostic exam is performed.1,2
CAGE tests are widely considered by American clinicians to be reliable enough for their intended purpose. Having only four questions, there are practical limits on how accurate CAGE or most of its variants could be. However, CAGE is more than good enough for determining whether the test taker should seek further medical attention.1,2
Most types of CAGE tests have the following limitations:
Scoring the minimum number of “yeses” (two for a male and one for a female) in CAGE means that further assessment by a qualified psychiatrist may be necessary. You may also want to try other AUD screening tools designed that are designed to be self-administered.1,2,5
Early detection and treatment of AUD are often key to improving one’s recovery outcomes.6 Call our team at Boston Drug Treatment Centers at (857) 577-8193 to discuss your testing and treatment options.
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