title: Detecting risk drinking during pregnancy: a comparison of four screening questionnaires.
abstract: OBJECTIVE
  This study investigated the efficacy of screening for risk drinking during pregnancy with two brief questionnaires, TWEAK and T-ACE. Both include an assessment of tolerance based on the number of drinks women report they can hold.
  
  
  METHODS
  Subjects were disadvantaged African-American obstetric patients in Detroit, Mich. Traditional alcoholism screens (Michigan Alcohol Screening Test [MAST], CAGE) and the tolerance question were administered (n = 2717); TWEAK and T-ACE were constructed from tolerance and embedded MAST and CAGE items. In a separate sample (n = 1420), only the T-ACE was administered. Periconceptional risk drinking was the gold standard. Screen evaluations were based on receiver-operating characteristic analyses.
  
  
  RESULTS
  At the cutpoint of 2, sensitivity/specificity for embedded screens were 91/77 for TWEAK and 88/79 for T-ACE; comparable values for T-ACE alone were 67/86. TWEAK and T-ACE screened more effectively than CAGE or MAST.
  
  
  CONCLUSIONS
  Embedded versions of TWEAK and T-ACE were both highly sensitive to periconceptional risk drinking in this population. Administering T-ACE alone reduced its sensitivity; this suggests that MAST and CAGE administration improves its performance.
authors.affiliation: Research Institute on Addictions, Buffalo, NY 14203, USA.
authors.forename: M
authors.initials: M
authors.lastname: Russell
authors.forename: S S
authors.initials: SS
authors.lastname: Martier
authors.forename: R J
authors.initials: RJ
authors.lastname: Sokol
authors.forename: P
authors.initials: P
authors.lastname: Mudar
authors.forename: S
authors.initials: S
authors.lastname: Jacobson
authors.forename: J
authors.initials: J
authors.lastname: Jacobson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000175:diagnosis*; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008824:Michigan / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires