Screening Tests

Question 1

AUDIT
test
use
score
sens/spec

Answer 1

test = 10 Q self-admin @ freq, binge, quant, depend, related problems
use = etoh risk, not just dependence
score = + is >8 males, >4 females
sens/spec = 0.8, 0.89 (go to diagnostic testing)

Question 2

CAGE / CAGE-AID
test
use
score
sens/spec

Answer 2

test = Cut down, Annoyed, Guilty, Eyeopener
use = EtOH dependence only
score = + 2 or more yes
sens/spec = 90% predictive of dependence

CAGE-AID - adapted to include drugs

Question 3

NIAAA
test
use
score
sens/spec

Answer 3

test = 1Q do you sometimes drink in a day >5 male, >4 female
use = screen EtOH
score = yes to only question is positive
sens/spec

Question 4

AUDIT-c
test
use
score
sens/spec

Answer 4

test = binge and frequency Qs
use = EtOH hazardous use
score = 0-12, positive >4 male, >3 female
sens/spec = more sensitive than AUDIT

Question 5

MAST / DAST
test
use
score
sens/spec

Answer 5

MAST = Michigan Alcohol screening test, or Drug Abuse screening test
use = M - EtOH, D - Drugs
score = both positive at 6
MAST 0-2 neg, 3-5 mild/early, 6 or up severe
sens/spec = highly sensitive
MAST G - more sensitive in geriatrics

Question 6

ASSIST / NIDA-mod ASSIST / computer ASSIST ACASI
test
use
score
sens/spec

Answer 6

test = 7Q / substance developed for SBIRT purpose
use = assess 10 substances and if IVDA present for SBIRT
score = per substance
sens/spec = screening

ACASI is computer assisted

Question 7

SBIRT

Answer 7

not a screening tool
Screen
Brief Intervention
Referral for Treatment

Question 8

TWEAK
test
use
score
sens/spec

Answer 8

test = 5Q
use = in PREGNANT females for harmful use of EtOH, determining tolerance/sensitivity
score = positive if >2
sens/spec = most sensitive in pregnant population

Question 9

TACE
test
use
score
sens/spec

Answer 9

test = 4Q, Tolerance, Annoyed, Cutdown, Eyeopener
use = detect heavy EtOH use in PREGNANT females
score = + is >2
sens/spec = more sensitive in pregnant female to get into services

Question 10

CRAFFT
test
use
score
sens/spec

Answer 10

test = 6Q
use = pediatric population
score = 0-1 counsel, >2 intervention
sens/spec = score 4-6 has 80% predictive value for future SUD

Question 11

4Ps
test
use
score
sens/spec

Answer 11

test = Parents/Partner/Past/Pregnancy
use = detect low use of EtOH in pregnant patients
score =
sens/spec = screening only to detect mild use, but increased concern secondary to pregnant state

Question 12

Withdrawal Scales per Substance
CIWA
CSSA
SOWS
OOWS
COWS

Answer 12

CIWA - EtOH
CSSA - Cocaine Selective Severity Assessment
SOWS - Opiates (subj) 16Q
OOWS - Opiates (obj) 10 signs
COWS - Opiates (subj & obj) 11 items

Question 13

Preferred Screening Per Population:
Geriatrics
Pregnancy
Pediatrics
Gambling

Answer 13

Geriatrics - MAST-G
Pregnancy - 4Ps, TWEAK, TACE
Pediatrics - CRAFFT
Gambling - SOGS

Question 14

Screens for Opiate RX Appropriateness

Answer 14

ORT = Opiate Risk Tool for Adults with PCP, 0-3 low risk, 4-7 mod risk, > 8 high risk for abuse of RX

SOAPP = Screener and Opioid Assessment for
Patients with Pain for those with pain to start opiates OR continue tx
<9 low, 10-21mod, >22 high OR >18 risk cutoff

DIRE = “candidacy” for long term opiate analgesia tx, low score 7-13 POOR candidate, higher score 14-21 good candidate, poor evidence for tool, but remains recommendation in pain medicine specialties

Question 15

COWS

Answer 15

11 subcategories
5-12 MILD WDWL
12-24 MOD WDWL
25-36 MOD SEVERE WDWL
>36 SEVERE WDWL