Smith G Richard, Burnam M Audrey, Mosley Cynthia L, Hollenberg Jan A, Mancino Mike, Grimes Wen
Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 West Markham Street, SL 554, Little Rock, AR 72205, USA.
Psychiatr Serv. 2006 Oct;57(10):1452-60. doi: 10.1176/ps.2006.57.10.1452.
The study sought to determine the validity and reliability of the Substance Abuse Outcomes Module (SAOM), a self-report tool designed to assess patient characteristics, process of care, and outcomes of care, using a minimum amount of information, in order to improve treatment.
A longitudinal field test (baseline and three-month follow-up) compared the SAOM to seven other research instruments in the assessment of 100 substance-abusing patients who were entering a new treatment episode. Quota samples of patients were drawn from two private inpatient substance abuse treatment facilities and an outpatient methadone clinic. The study's primary outcome measures were diagnostic accuracy, internal and test-retest reliability of key constructs, concurrent and predictive validity, and sensitivity to change. Cronbach's alpha coefficients were calculated to examine internal consistency and reliability. Intraclass correlation coefficients and kappa coefficients were used to examine test-retest reliability. Concurrent validity of outcomes measures was examined with Pearson or Spearman correlation coefficients and chi square and kappa statistics. Changes between baseline and follow-up were examined as a function of case-mix measures with ordinary least-squares multiple regression. Sensitivity to change was examined by calculating effect size scores.
The SAOM had high internal consistency and a high level of agreement with research diagnoses at baseline and follow-up. The SAOM was found to be highly reliable, to have very strong validity, and to be sensitive to clinical change.
The SAOM appears to be a reasonably reliable and valid self-report instrument when used to monitor substance abuse treatment among patients with a primary substance use diagnosis.
本研究旨在确定物质滥用结果模块（SAOM）的有效性和可靠性。SAOM是一种自我报告工具，旨在使用最少的信息来评估患者特征、护理过程和护理结果，以改善治疗效果。
一项纵向现场试验（基线和三个月随访）将SAOM与其他七种研究工具进行了比较，对100名开始新治疗阶段的物质滥用患者进行评估。患者配额样本来自两家私立住院物质滥用治疗机构和一家门诊美沙酮诊所。该研究的主要结局指标包括诊断准确性、关键结构的内部信度和重测信度、同时效度和预测效度以及对变化的敏感性。计算克朗巴哈系数以检验内部一致性和信度。组内相关系数和kappa系数用于检验重测信度。结局指标的同时效度通过Pearson或Spearman相关系数以及卡方和kappa统计量进行检验。基线和随访之间的变化通过普通最小二乘多元回归作为病例组合指标的函数进行检验。通过计算效应大小得分来检验对变化的敏感性。
SAOM在基线和随访时具有较高的内部一致性，与研究诊断的一致性程度较高。研究发现，SAOM具有高度的可靠性、非常强的效度，并且对临床变化敏感。
当用于监测主要物质使用诊断患者的物质滥用治疗时，SAOM似乎是一种相当可靠且有效的自我报告工具。
