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Poorly Diagnostic Findings

Alcoholism: Sensitivity and Specificity

Introduction: Alcoholism is a disease "characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortion of thinking, most notably denial".

Alcohol abuse = a maladaptive pattern of use associated with one or more of the following:

  • Failure to fulfill work, school, or social obligations
  • Recurrent substance use in physically hazardous situations
  • Recurrent legal problems related to substance use
  • Continued use despite alcohol-related social or interpersonal problems
  • Alcohol dependence = maladaptive pattern of use associated with three or more of the following:

  • Tolerance
  • Withdrawal
  • Substance taken in larger quantity than intended
  • Persistent desire to cut down or control use
  • Time is spent obtaining, using, or recovering from the substance
  • Social, occupational, or recreational tasks are sacrificed
  • Use continues despite physical and psychological problems
  • [Edit Diagnosis] [Merge dx] [Add prevalence]

    Tags: Hepatic Psychiatric Toxic Tag this Diagnosis.

    Differential Diagnoses include: Nonalcoholic Steatohepatitis


    Population / CalculatorPrevalence Comments / Study / Link
    Primary Care 5% Ann Intern Med 2004 Apr 6;140(7):554-6. PMID 15068984
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    The sensitivity and specificity of findings for Alcoholism are listed below. See the left navigation bar to change the display.

    Pre-Test Probability (Prevalence): %. Post-Test Probability (Predictive Value): %. Switch to display mode.
    **Note that calculating probabilities from more than one finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)
    Specific Findings
    FindingResult SensitivitySpecificity
    [ + ] AST > ALT + 0 - 50%97%
    [ + ] CAGE Questionnaire + 0 - 74%91%
    [ + ] Elevated ALT + 0 - 35%86%
    [ + ] Elevated Carbohydrate-Deficient Transferrin + 0 - 65%85%
    [ + ] Increased MCV + 0 - 40%85%
    Poorly Diagnostic Findings
    FindingResult SensitivitySpecificity
    [ + ] Elevated AST + 0 - 50%82%
    [ + ] Elevated GGT + 0 - 70%70%