GetTheDiagnosis.org

Welcome, guest.
Login or Sign up to edit.

Add an entry

Search:
 

Tools

Add a finding for this diagnosis

Add prevalence for this diagnosis

Switch to calculator mode to see positive predictive value

Switch to likelihood ratios

Sort findings by Tag

Sort findings by Differential Diagnosis

Jump To

Specific Findings

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

    Prevalence

    Population / CalculatorPrevalence Comments / Study / Link
    Primary Care 5% Ann Intern Med 2004 Apr 6;140(7):554-6. PMID 15068984
    More, Edit...

    The sensitivity and specificity of findings for Alcoholism are listed below. See the left navigation bar to change the display.

    Specific Findings

    Finding SensitivitySpecificity Comments, Study
    AST > ALT Edit 50%97%

    ratio >2.0

    both usually <300 IU/L, and almost never >500 IU/L

    Differential Diagnosis: Nonalcoholic Steatohepatitis

    Study: (data back-calculated from the corresponding data for NASH by AST/ALT <= 2)

    Am J Gastroenterol. 1999 Apr;94(4):1018-22. PMID 10201476

    CAGE Questionnaire Edit 74%91%

    >=2 questions positive:

  • Have you ever felt the need to Cut down on drinking?
  • Have you ever felt Annoyed by criticism of your drinking?
  • Have you ever had Guilty feelings about your drinking?
  • Do you ever take a morning Eye opener (a drink first thing in the morning to steady your nerves or get rid of a hangover)?
  • Study: Ann Intern Med 1991 Nov 15;115(10):774-7. PMID 1929025

    Elevated ALT Edit 35%86%

    Study: See table in: http://www.utdol.com/online/content/topic.do?topicKey=hep_dis/7556

    From Alcohol Clin Exp Res 1994 Oct;18(5):1103-8. and Arch Intern Med 1995 Sep 25;155(17):1907-11.

    Elevated Carbohydrate-Deficient Transferrin Edit 65%85%

    Study: See table in: http://www.utdol.com/online/content/topic.do?topicKey=hep_dis/7556

    From Alcohol Clin Exp Res 1994 Oct;18(5):1103-8. and Arch Intern Med 1995 Sep 25;155(17):1907-11.

    Increased MCV Edit 40%85%

    i.e. mean corpuscular volume

    Study: See table in: http://www.utdol.com/online/content/topic.do?topicKey=hep_dis/7556

    From Alcohol Clin Exp Res 1994 Oct;18(5):1103-8. and Arch Intern Med 1995 Sep 25;155(17):1907-11.

    Poorly Diagnostic Findings

    Finding SensitivitySpecificity Comments, Study
    Elevated AST Edit 50%82%

    Study: See table in: http://www.utdol.com/online/content/topic.do?topicKey=hep_dis/7556

    From Alcohol Clin Exp Res 1994 Oct;18(5):1103-8. and Arch Intern Med 1995 Sep 25;155(17):1907-11.

    Elevated GGT Edit 70%70%

    Study: See table in: http://www.utdol.com/online/content/topic.do?topicKey=hep_dis/7556

    From Alcohol Clin Exp Res 1994 Oct;18(5):1103-8. and Arch Intern Med 1995 Sep 25;155(17):1907-11.