Vitale S G, van de Mheen H, van de Wiel A, Garretsen H F L
Addiction Research Institute (IVO), Heemraadssingel 194, 3021 DM Rotterdam, The Netherlands.
Addict Behav. 2006 Sep;31(9):1661-9. doi: 10.1016/j.addbeh.2005.12.011. Epub 2006 Jan 27.
To explore the validity of self-reported substance use among emergency room populations and the processes of sample selection bias, to establish their influence on the prevalence rates found.
Self-reported alcohol and illicit drug use of patients in the emergency room is compared with results from an alcohol breath analyser and urine toxicology.
Variations in reported substance use occur when comparing self-report measures with alcohol breath analyser results and urine toxicology. Self-reported alcohol use was found among 7.5% of the patients compared with 4.7% based on alcohol breath analysers. Illicit drug use was reported by 9.0% of the patients whereas urine toxicology resulted in 30% patients positive for illicit drug use. Patients that voluntarily participate in the study differ from those that do not participate. Patients who refuse an alcohol breath analyser report slightly more alcohol use prior to the injury (difference not significant), and patients who provide a urine sample report more illicit drug use prior to the injury compared to those that refuse.
Differences in prevalence rates can be explained partly by the measurements used and partly by sample selection bias. Self-reported alcohol use and self-reported illicit drug use are preferable to the "gold standard" when used among emergency room patients, because both measures provide more accurate information on the actual use. Sample selection bias also influences the prevalence rates.
探讨急诊室人群自我报告的物质使用情况的有效性以及样本选择偏差的过程，以确定它们对所发现的患病率的影响。
将急诊室患者自我报告的酒精和非法药物使用情况与酒精呼气分析仪和尿液毒理学检测结果进行比较。
将自我报告测量结果与酒精呼气分析仪结果及尿液毒理学结果相比较时，报告的物质使用情况存在差异。在患者中，自我报告有酒精使用的占7.5%，而基于酒精呼气分析仪的结果为4.7%。9.0%的患者报告有非法药物使用，而尿液毒理学检测显示30%的患者非法药物使用呈阳性。自愿参与研究的患者与未参与者不同。拒绝进行酒精呼气分析仪检测的患者在受伤前报告的酒精使用略多（差异不显著），与拒绝提供尿液样本的患者相比，提供尿液样本的患者在受伤前报告的非法药物使用更多。
患病率的差异部分可由所使用的测量方法解释，部分可由样本选择偏差解释。在急诊室患者中使用时，自我报告的酒精使用和自我报告的非法药物使用比“金标准”更可取，因为这两种测量方法都能提供关于实际使用情况的更准确信息。样本选择偏差也会影响患病率。
