Michigan Alcohol Screening Test (MAST) Calculator

How does this Michigan Alcohol Screening Test (MAST) calculator work?

This health tool aims to screen different populations for alcoholism and alcohol abuse.

Being one of the most widely used alcoholism tests, it focuses on abuse, signs of alcoholism and lifetime consequences. The Michigan alcohol screening test (MAST) calculator uses the complete version but shorter versions with the most significant questions in the MAST have also been created.

The first version was published by Professor Selzer in the American Journal of Psychiatry in 1971 and to date is the oldest screening test with effectiveness rates of up to 98%.

The test itself can be self administered with questions that allow the subject to visualize the extent of alcohol use impact on lifestyle, social and family situations.

The main criticism received by this alcoholism test refers to its length, that makes it hard to be utilized as screening method in emergency departments. At the same time, there are discussions concerning the objectivity and applicability of the test in the current patient situation, and as early detector of alcohol abuse, as most questions refer to an undefined lifetime period rather than the present.

MAST score interpretation

Each of the 24 questions in this alcoholism test is answered by either yes or no, each of the choices having weights of 0, 1, 2 and 5 points. Usually one answer scores 0 points while the opposite answer scores 1, 2 or 5 points.

Unlike other assessments that can be quite straightforward, MAST is fairly more complex to score as it depends on whether the item wording is positive or negative.

Items 1, 4, 6 and 7 demand that negative answers to be consistent with alcoholism problems while items 2, 3, 5 and 9 to 25 demand that positive answers to be consistent with alcoholism signs and weight more points.

Another exception occurs in questions 23 and 24 where each arrest situation, if existing, is multiplied by the number of points.

In terms of answer weights, questions with high discriminating properties are given 5, respectively 2 points while the rest are given just one point:

■ Scores between 0 and 3 indicate no apparent alcoholism problems.

■ Scores of 4 are consistent with early or middle alcoholism.

■ Scores of 5 and above correlate with aggravated alcoholism diagnosis.

There is some criticism to the MAST scoring system, especially concerning its sensitivity at the cut off level of 5 points and the tendency to screen more people in the alcoholic range. However, due to its screening properties, the consensus remains that sensitivity needs to be heightened at lower values.

Other alcohol screening tests

These are tools that help clinicians and other care providers to detect patients suffering from alcohol abuse at different stages and varying severity degrees:

■ AUDIT-C – very popular screening method consisting of 10 questions about alcohol related habits. The name stands for Alcohol Use Disorders Identification Test Consumption.

■ The FAST alcohol screening test  - 4 question rapid alcohol abuse test focusing on hazardous drinking. This is one of the tests performed in ER and is considered the shortest validated alcoholism screening method.

■ The CRAFFT screening test – addresses alcohol and drug abuse in adolescents based on habits and other risk factors in a 6 item questionnaire.

References

1) Selzer ML. (1971) The Michigan Alcoholism Screening Test (MAST): The quest for a new diagnostic instrument. American Journal of Psychiatry, 127:1653-1658.

2) Maisto SA, Connors GJ, Allen JP. (1995) Contrasting self-report screens for alcohol problems: A review. Alcoholism: Clinical and Experimental Research, 19(6):1510-1516.

3) Teitelbaum L, Mullen B. (2000) Validity of the MAST in psychiatric settings: A META-analytic integration. Michigan Alcoholism Screening Test. Journal of Studies on Alcohol, 61(2):254-261.