Screening for alcohol problems: A comparison of instrument performance between the ER and the general population among Mexican Americans in the US and Mexicans in Mexico

Relatively little is known about the performance of screening instruments for alcohol use disorders in the general population compared to clinical populations, or among Mexicans or Mexican Americans. The sensitivity and specificity of three screening measures: CAGE, TWEAK, and holding five or more drinks (HOLD), for alcohol dependence, are compared between ER and general population samples in the U.S. (Santa Clara, County, California) and in Mexico (Pachuca). In Pachuca sensitivity of the TWEAK and HOLD was significantly better in the general population compared to the ER, while in Santa Clara sensitivity of the CAGE was significantly better in the ER compared to the general population. HOLD appeared to perform better in the general population than in the ER in Santa Clara. The data suggest differential performance of screening instruments among Hispanics in the general population compared to the ER in both the U.S. and Mexico, and HOLD may be the measure of choice for identifying alcohol use disorders in the Hispanic general population.