The T-ACE questionnaire can be used to screen a patient for alcohol abuse. It has often been used in screening women during pregnancy for problem drinking.



(1) T – tolerance

(2) A – annoyance

(3) C – cut down

(4) E – eye-opener



• Some questionnaires use different alcohol intake levels for men and women. A value of >= 3 seems appropriate for women. A higher value (perhaps >= 5) may be necessary for men.

• A single drink has about 0.5 ounces of absolute alcohol.

• The "T-ACE" comes from 2 points for T and 1 point for ACE responses.


Modified questionnaire:

(1) A later version (Russell, 1996) changed the first item from the number of drinks for feeling high to the number of drinks that the person could hold. For women, this was considered positive when >= 6 drinks.

(2) In the implementation I assumed that a man would have a higher number of drinks for tolerance, and set this arbitrarily to >= 8 drinks.


total score =

= SUM(points for all 4 items)



• minimum score: 0

• maximum score: 5

• A score >= 2 was considered positive (sensitivity 69% for risk drinkers, specificity 89%, positive predictive value 23%) in the data of Sokol et al

• A score >= 3 was considered positive (sensitivity 38% for risk drinkers, specificity 97%, positive predictive value 40%) in the data of Sokol et al

• As with other screening questionnaires, a positive score needs to be followed by an additional evaluation before a definitive diagnosis of ethanol abuse is made.


Odds Ratio



T only


A only


C only


E only


all 4 items


from Table IV, page 865 Sokol et al (1989)



• The odds ratio for all 4 items is the product of the component odds ratios.


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