CAGE Alcohol Screening Questionnaire
A brief 4-item yes/no screener for clinically significant alcohol problems. The total is compared to the standard cutoff. Intended for use under clinician supervision.
This is a clinical instrument. It is not publicly self-administered — a clinician assigns it through a secure patient link.
At a glance
What it measures
The CAGE questionnaire (Ewing, 1984) is a 4-item yes/no screen for clinically significant alcohol problems, its name an acronym of its four questions (Cut down, Annoyed, Guilty, Eye-opener). Per Ewing (1984), a total of 2 or more is considered clinically significant.
Its brevity makes it a common first-pass screen in medical settings; a positive screen calls for a fuller alcohol-use assessment rather than standing as a conclusion on its own.
Psychometric properties
The notes below are reproduced from the platform's psychometrics register for this instrument — the same source-cited reliability, validity, and norms text that accompanies its downloadable report.
A brief 4-item screen; internal consistency is modest given its length, but it is widely validated for case-finding (Dhalla & Kopec, 2007).
At a cutoff of 2 or more, pooled sensitivity is about 0.71 and specificity about 0.90 for alcohol abuse and dependence (Dhalla & Kopec, 2007).
Introduced by Ewing (1984); two or more positive responses warrant further assessment.
Example item
“Have you ever felt you should cut down on your drinking?”
Illustrative only. During administration items are presented one screen-set at a time; response-key direction is never shown to respondents.
Scoring & interpretation
Item responses are summed to a total score and compared against published screening cutoffs.
| Band | Threshold | Interpretation |
|---|---|---|
| Screen negative | ≥ 0 | No items endorsed. A clinically significant alcohol problem is unlikely based on this screen alone. |
| Borderline | ≥ 1 | One item endorsed. Many clinicians treat any positive response as grounds for further inquiry about drinking. |
| Screen positive | ≥ 2 | Two or more items endorsed — clinically significant; further assessment for an alcohol use disorder is recommended. |
Source & citation
Ewing, J. A. (1984). Detecting alcoholism: The CAGE questionnaire. JAMA, 252(14), 1905–1907. Freely available for clinical use.
Scoring. Cutoff threshold per Ewing, J. A. (1984). Detecting alcoholism: The CAGE questionnaire. JAMA, 252(14), 1905–1907 (a score of 2 or more is considered clinically significant).
CAGE questionnaire (Ewing, J. A., 1984). Free for clinical and research use with attribution.
References
- Ewing, J. A. (1984). Detecting alcoholism: the CAGE questionnaire. JAMA, 252(14), 1905-1907.
- Dhalla, S., & Kopec, J. A. (2007). The CAGE questionnaire for alcohol misuse: a review of reliability and validity studies. Clinical and Investigative Medicine, 30(1), 33-41.