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Military Combat Deployment and Alcohol Use—Reply
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In Reply: We agree with Drs Dervaux and Laqueille that using a score of 2 or more for the CAGE questionnaire increases specificity while decreasing sensitivity when screening patients for alcohol abuse or dependence.1-2 In a study of alcohol dependence, higher specificity may be more desirable. However, the purpose of our study was to investigate changes in alcohol use behaviors and alcohol-related problems before and after combat deployment, using the metrics of heavy weekly drinking, binge drinking, and alcohol-related problems defined by the Patient Health Questionnaire.3 The CAGE screening questions in our study were used to adjust for confounding related to the existence of potential alcohol-related problems prior to the baseline questionnaire. We elected to use a more sensitive definition of 1 or more affirmative responses on the CAGE, which was the cutoff established when the questions were first developed and has been deemed useful in other studies,4-5 to improve . . . [Full Text of this Article]
Isabel G. Jacobson, MPH
isabel.jacobson@med.navy.mil
Tyler C. Smith, MS, PhD
Department of Defense Center for Deployment Health Research
Naval Health Research Center
San Diego, California
Nicole S. Bell, ScD, MPH
Social Sectors Development Strategies
Tacoma, Washington
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RELATED LETTER
Military Combat Deployment and Alcohol Use
Alain Dervaux and Xavier Laqueille
JAMA. 2008;300(22):2606-2607.
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