CAGE Questionnaire

Download Clinical Summary PDF

Tool Description

  • 4 item screening questionnaire used to identify those individuals for whom more extensive evaluation of alcohol use is recommended
  • the oldest and likely most extensively used questionnaire across a variety of clinical and research settings. Originally developed for use with adults, it has been used in elderly populations as well.  

ICF Domain:

Body Function – Subcategory: Mental Functions.

Number of Items:

4

Brief Instructions for Administration & Scoring

Administration:

  • self report pen/paper or interview format.
  • Time for administration is approximately 5 minutes.
  • Responses of “yes/no” to the following:
  • Have you ever felt you should Cut down on your drinking?
  • Have people Annoyed you by criticizing your drinking?
  • Have you ever felt bad or Guilty about drinking?
  • Have you ever taken a drink first thing in the morning (Eye opener) to steady your nerves or get rid of a hangover?

Equipment:None.

Scoring:

  • Typically, two or more of the questions answered affirmatively are considered to be “CAGE positive”, though some suggest a positive response to a single item warrants more in-depth investigation of consumption.  

Interpretability

MCID: not established
SEM: not established
MDC: not established

  • Score correlates positively with pre-SCI consumption patterns and a greater incidence of medical complications (Tate 2003).
  • In non-SCI populations, the CAGE test scores >=2 has a sensitivity of 93% and a specificity of 76% for the identification of problem drinkers (Bernadt et al. 1982). There have been recommendations to lower the cutoff to a score of 1 for the identification of problem drinkers.
  • no cut-points or normative data have been established for the SCI population
  • published data for the SCI population is available for comparison (see the Interpretability section of the Study Details sheet).

Languages:

English

Training Required:

None

Availability:

Freely available online

Clinical Considerations

  • Susceptible to underreporting. Minimum age 16 years, and not recommended for use with adolescents. 
  • Questions refer to whole life history rather than a particular period. Thus, the questionnaire does not discriminate between active and inactive drinkers and should be used in combination with information regarding usual consumption patterns (e.g., frequency/quantity/heaviest consumption). In some populations, such inquiry can inhibit responses to CAGE questions, if it precedes them. 
  • The CAGE contains sensitive items, therefore clinicians should take care to carefully present the questions.
  • The CAGE is simple and easy to administer.

Measurement Property Summary

# of studies reporting psychometric properties: 1

Reliability:

No values were reported for the reliability of the CAGE questionnaire for the SCI population.

Validity:

  • The CAGE questionnaire had significant correlations with:
    •  self-reported alcohol abuse history (r=0.53)
    • average number of drinks consumed weekly prior to injury (r=0.38)
    • drug abuse history (r=0.28).

[Tate et al. 1993]

Responsiveness:

No values were reported for the responsiveness of the CAGE questionnaire for the SCI population.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the CAGE questionnaire for the SCI population.

Reviewer

Dr. Janice Eng, Christie Chan

Date Last Updated:

Feb 1, 2013

Download the measure

Download Worksheet:
Can be found at: http://www.integration.samhsa.gov/clinical-practice/sbirt/CAGE_questionaire.pdf

Video

n/a

Scoring

Equipment Needed

CAGE:

Bernadt MW, Mumford J, Taylor C, Smith B, Murray RM. Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism. Lancet 1982;1:325–328.
http://www.ncbi.nlm.nih.gov/pubmed/6120322

Ewing JA. Detecting Alcoholism: The CAGE Questionnaire. JAMA 1984; 252:1905-1907.
http://jama.jamanetwork.com/article.aspx?articleid=394693

Tate D. Alcohol Use Among Spinal Cord Injured Patients. Am J Phys Med Rehabil 1993;72:175-183.
http://www.ncbi.nlm.nih.gov/pubmed/8363813