Regarding screening for alcohol dependence, which of the following is not a question on the RAPS4?
Have you had a feeling of guilt or remorse after drinking?20%Has a friend or a family member ever told you about things you said or did while you were drinking that you could not remember?21%Have you failed to do what was normally expected of you because of drinking?16%Do you sometimes take a drink when you first get up in the morning?21%Have people annoyed you by criticising your drinking?22%
Alcohol screening tools
A variety of tools have been devised to assist in the diagnosis of alcohol problems.
AUDIT (Alcohol Use Disorders Identification Test), was developed by the WHO as a simple method of screening for excessive drinking. The test consists of 10 questions and attempts to cover the three domains of harmful use, hazardous use, and dependence.
- 10 item questionnaire
- Takes about 2-3 minutes to complete
- Has been shown to be superior to CAGE and biochemical markers for predicting alcohol problems
- Minimum score = 0, maximum score = 40
- A score of 8 or more in men, and 7 or more in women, indicates a strong likelihood of hazardous or harmful alcohol consumption
- A score of 15 or more in men, and 13 or more in women, is likely to indicate alcohol dependence
- AUDIT-C is an abbreviated form consisting of 3 questions
http://libdoc.who.int/hq/2001/WHOMSDMSB01.6a.pdf
FAST (Fast Alcohol Screening Test), is a short and rapid test with just 4 questions that was developed to be used in a busy medical setting.
- 4 item questionnaire (see table below)
- Minimum score = 0, maximum score = 16
- The score for hazardous drinking is 3 or more
- With relation to the first question 1 drink = 1/2 pint of beer or 1 glass of wine or 1 single spirits
- If the answer to the first question is 'never' then the patient is not misusing alcohol
- If the response to the first question is 'Weekly' or 'Daily or almost daily' then the patient is a hazardous, harmful or dependent drinker. Over 50% of people will be classified using just this one question
| Number | Question |
|---|---|
| 1 | MEN: How often do you have EIGHT or more drinks on one occasion? WOMEN: How often do you have SIX or more drinks on one occasion? |
| 2 | How often during the last year have you been unable to remember what happened the night before because you had been drinking? |
| 3 | How often during the last year have you failed to do what was normally expected of you because of drinking? |
| 4 | In the last year has a relative or friend, or a doctor or other health worker been concerned about your drinking or suggested you cut down? |
http://alcoholism.about.com/od/tests/a/fast.htm
CAGE is a 4 question screening tool. Two or more positive answers suggests problem drinking.
The CAGE is a well known but recent research has questioned its value as a screening test two or more positive answers is generally considered a 'positive' result.
| Letter | Question |
|---|---|
| C | Have you ever felt you should Cut down on your drinking? |
| A | Have people Annoyed you by criticising your drinking? |
| G | Have you ever felt bad or Guilty about your drinking? |
| E | Have you ever had a drink in the morning to get rid of a hangover (Eye opener)? |
SASQ (Single alcohol screening questionnaire), asks only one question, when was the last time you had more than x alcoholic drinks in one day? (Where x is 8 for men and 6 for women). An answer of within 3 months indicates harmful or hazardous drinking.
PAT (Paddington Alcohol Test), was developed for use in a busy A&E department to detect hazardous drinking.
MAST (Michigan Alcoholism Screening Test) is useful for detecting dependent drinkers.
Rapid Alcohol Problem Screen 4 (RAPS4) Consists of four questions and has been found to be highly effective in detecting alcohol dependence. A 'yes' answer to at least one of the four questions suggests that your drinking is harmful.
| Letter | Question |
|---|---|
| R (remorse) | Have you had a feeling of guilt or remorse after drinking? |
| A (amnesia) | Has a friend or a family member ever told you about things you said or did while you were drinking that you could not remember? |
| P (performance) | Have you failed to do what was normally expected of you because of drinking? |
| S (starter drinker behaviour) | Do you sometimes take a drink when you first get up in the morning? |
