Alcohol and drug dependence symptom items as brief screeners for substance use disorders: results from the Clinical Trials Network.

paper Cited Public

Authors: Wu, Li-Tzy; Blazer, Dan G; Woody, George E; Burchett, Bruce; Yang, Chongming; Pan, Jeng-Jong; Ling, Walter
Year: 2012
Journal: Journal of psychiatric research
PMID: 22204775
DOI: 10.1016/j.jpsychires.2011.12.002
PMCID: PMC3289153

Fig. 1

Past-year prevalence (%) of substance-specific dependence symptoms among substance users in a sample of treatment-seeking, opioid-dependent adults (N=920).

Fig. 2

Fig. 2a. An item response analysis of alcohol dependence symptoms among 672 alcohol users in a sample of treatment-seeking, opioid-dependent adults.Fig. 2b. An item response analysis of amphetamine dependence symptoms among 156 amphetamine users in a sample of treatment-seeking, opioid-dependent adults.Fig. 2c. An item response analysis of cannabis dependence symptoms among 497 cannabis users in a sample of treatment-seeking, opioid-dependent adults.Fig. 2d. An item response analysis of cocaine dependence among 609 cocaine users in a sample of treatment-seeking, opioid-dependent adults.Fig. 2e. An item response analysis of sedative dependence symptoms among 419 sedative users in a sample of treatment-seeking, opioid-dependent adults.

Fig. 3

Area under the receiver operating characteristic curve (ROC-AUC) for classifying cases versus non-cases of a substance use disorder, by substance-specific dependence symptoms. Lines extending from bars indicate 95% confidence intervals of the estimates.

Fig. 4

Fig. 4a. Sensitivity of classifying cases versus non-cases of a substance use disorder, by substance-specific dependence symptoms. Lines extending from bars indicate 95% confidence intervals of the estimates.Fig. 4b. Specificity of classifying cases versus non-cases of a substance use disorder, by substance-specific dependence symptoms. Lines extending from bars indicate 95% confidence intervals of the estimates.

#	Section	Preview
20	3. Results — 3.4. IRT analysis and ROC-AUC of dependence symptom items	As shown in item characteristic curves (ICCs) that considered item-level discrimination and severity…
21	3. Results — 3.4. IRT analysis and ROC-AUC of dependence symptom items	To explore whether the IRT item-level estimates suggested similar information as…
22	3. Results — 3.5. Sensitivity and specificity of dependence symptom items	To help evaluate ROC-AUC estimates, sensitivity and specificity estimates are presented in Fig. 4a…
23	4. Discussion — 4.1. Main findings	To address the urgent need for brief screening tools in keeping with the national priority to…
24	4. Discussion — 4.1. Main findings	using for alcohol and sedatives; giving up activities for sedatives). These results demonstrate the…
25	4. Discussion — 4.2. IRT and ROC-AUC indicate similar item-level results across substances	Due to competing priorities and time constraints in medical settings, brevity is crucial for…
26	4. Discussion — 4.2. IRT and ROC-AUC indicate similar item-level results across substances	To address this gap, we examined substance-specific screening questions and observed somewhat…
27	4. Discussion — 4.2. IRT and ROC-AUC indicate similar item-level results across substances	demonstrated good-to-high ROC-AUC values in specifying cases of a SUD. For instance, sensitivity for…
28	4. Discussion — 4.3. Implications for SUD screening and use of electronic health records (EHR)	These results have timely implications for the development of EHR systems and collection of…
29	4. Discussion — 4.3. Implications for SUD screening and use of electronic health records (EHR)	complete. Therefore, brevity and accuracy in detecting SUDs are critical considerations for…
30	4. Discussion — 4.3. Implications for SUD screening and use of electronic health records (EHR)	Presently, single-item screeners for “substance use” have been identified (Smith et al., 2009;…
31	4. Discussion — 4.3. Implications for SUD screening and use of electronic health records (EHR)	Lastly, cocaine dependence was the most prevalent comorbid SUD in this sample. Co-abuse of opioids…
32	4. Discussion — 4.4. Limitations and strengths	These results are based on treatment-seeking, opioid-dependent adults, and the sample is not…
33	4. Discussion — 4.4. Limitations and strengths	Strengths include the rigorous conduct of the original trial (standardized assessments,…
34	4. Discussion — 4.5. Conclusions	While IRT analysis has played a key role in the psychometric evaluation of health-related item banks…

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