[An evaluation of the SMAST questionnaire for the diagnosis of alcoholism in primary care. The Self-Administered Short Michigan Alcoholism Screening Test].
OBJECTIVE
To validate a self-administrable version of the SMAST questionnaire for diagnosing alcoholism at the primary care level.


METHODS
A descriptive study of a crossover type.


METHODS
An urban health centre.


METHODS
497 patients over 15, selected at random from the log-book of daily demand, answered the questionnaire. 46 patients with 2 or more positive replies concerning alcoholism (SMAST positive) were invited to a subsequent appointment, as were 40 with a lower score (SMAST negative). 30 from each group attended.


RESULTS
The presence of alcoholism was examined by looking at the compliance with the diagnostic criteria of the DSM-III-R and/or the existence of alcohol consumption equal to or above 30 grams a day in women and 60 in men, in those patients who attended the subsequent appointment. 20 SMAST++ positives and two negatives were diagnosed as alcoholics. There was good correlation between daily alcohol consumption in grams and SMAST scoring (r = 0.60; CI's 95%: 0.41-0.74). SMAST showed 50.48% sensitivity, 96.48% specificity and positive and negative predictive values of 66.67% and 93.33%, respectively. By means of a logistical regression analysis, it was clearly shown that the SMAST questions which best forecast the existence of alcoholism were the first two.


CONCLUSIONS
The SMAST questionnaire is a very specific test for diagnosing alcoholism within primary care, although its only moderate sensitivity does not recommend it for screening purposes.
Escobar
F
F
Centro de Salud Zona IV, Albacete.
González
C
C
López
J L
JL
Vercher
R
R
Arnal
J A
JA
Galdámez
A M
AM
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology; D016009:Chi-Square Distribution; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011897:Random Allocation; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology
Validación del cuestionario SMAST para el diagnóstico del alcoholismo en atención primaria.