- 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.
Body Function – Subcategory: Mental Functions.
Number of Items:
Brief Instructions for Administration & Scoring
- 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?
- 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.
- 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).
Freely available online
- 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
No values were reported for the reliability of the CAGE questionnaire for the SCI population.
- 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]
No values were reported for the responsiveness of the CAGE questionnaire for the SCI population.
No values were reported for the presence of floor/ceiling effects in the CAGE questionnaire for the SCI population.
Dr. Janice Eng, Christie Chan, Gita Manhas
Date Last Updated:
July 20, 2020
Download the measure
Can be found at: http://www.integration.samhsa.gov/clinical-practice/sbirt/CAGE_questionaire.pdf
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.
Ewing JA. Detecting Alcoholism: The CAGE Questionnaire. JAMA 1984; 252:1905-1907.
Tate D. Alcohol Use Among Spinal Cord Injured Patients. Am J Phys Med Rehabil 1993;72:175-183.