Evaluating brief screeners to discriminate between drug use disorders in a sample of treatment-seeking adults - 15/01/13
, Marvin S. Swartz, M.D. a, Jeng-Jong Pan, Ph.D. b, Bruce Burchett, Ph.D. a, Paolo Mannelli, M.D. a, Chongming Yang, Ph.D. c, Dan G. Blazer, M.D., Ph.D. aAbstract |
Objective |
The objective was to identify a potential core set of brief screeners for the detection of individuals with a substance use disorder (SUD) in medical settings.
Method |
Data were from two multisite studies that evaluated stimulant use outcomes of an abstinence-based contingency management intervention as an addition to usual care (National Drug Abuse Treatment Clinical Trials Network trials 006–007). The sample comprised 847 substance-using adults who were recruited from 12 outpatient substance abuse treatment settings across the United States. Alcohol and drug use disorders were assessed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Checklist. Data were analyzed by factor analysis, item response theory (IRT), sensitivity and specificity procedures.
Results |
Comparatively prevalent symptoms of dependence, especially inability to cut down for all substances, showed high sensitivity for detecting an SUD (low rate of false negative). IRT-defined severe (infrequent) and low discriminative items, especially withdrawal for alcohol, cannabis and cocaine, had low sensitivity in identifying cases of an SUD. IRT-defined less severe (frequent) and high discriminative items, including inability to cut down or taking larger amounts than intended for all substances and withdrawal for amphetamines and opioids, showed good-to-high values of area under the receiver operating characteristic curve in classifying cases and noncases of an SUD.
Conclusion |
Findings suggest the feasibility of identifying psychometrically reliable substance dependence symptoms to develop a two-item screen for alcohol and drug disorders.
Le texte complet de cet article est disponible en PDF.Keywords : Clinical Trials Network, Item response theory, Receiver operating characteristic curve, Brief screening, Substance use disorders
Plan
| ☆ | Funding support: This work was made possible by research grants from the U.S. National Institute on Drug Abuse of the National Institutes of Health (R21DA027503, R33DA027503, R01DA019623, and R01DA019901 to Li-Tzy Wu; U10DA013034 to Maxine L Stitzer). The Duke University Institutional Review Board approved use of these data for this study. The National Institutes of Health had no role in the design and conduct of the study; analysis and interpretation of the data; and preparation, review, or approval of the manuscript. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. |
| ☆☆ | Disclosures: Marvin Swartz has served as a consultant to Novartis Pharmaceuticals and has received research support from Eli Lilly. Paolo Mannelli has received research support from Alkermes, Inc.; AstraZeneca; Bristol-Myers Squibb; Cephalon, Inc.; Forest Research Institute; GlaxoSmithKline; Janssen Pharmaceuticals (Johnson & Johnson); Jazz Pharmaceuticals; King Pharmaceuticals, Inc.; Lundbeck McNeil Consumer & Specialty Pharm.; Merck & Co. USA; Orphan Medical; Pfizer Inc.; Pondera Pharmaceuticals, Inc.; Reckitt Benckiser; Sunovion Pharm; and Titan Pharm. The other authors have no conflicts of interest to disclose. |
Vol 35 - N° 1
P. 74-82 - janvier 2013 Retour au numéro
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