Inflexxion, Inc., Newton.
Clin J Pain. 2010 Nov-Dec;26(9):770-6. doi: 10.1097/AJP.0b013e3181f195ba.
The Current Opioid Misuse Measure (COMM) is a self-report measure of risk for aberrant medication-related behavior among persons with chronic pain who are prescribed opioids for pain. It was developed to complement predictive screeners of opioid misuse potential and improve a clinician's ability to periodically assess a patient's risk for opioid misuse. The aim of this study was to cross-validate the COMM with a sample of chronic noncancer pain patients.
Two hundred and twenty-six participants prescribed opioids for pain were recruited from 5 pain management centers in the United States. Participants completed the 17-item COMM and a series of self-report measures. Patients were rated by their treating physician, had a urine toxicology screen, and were classified on the Aberrant Drug Behavior index.
The reliability and predictive validity in this cross validation as measured by the area under the curve (AUC) were found to be highly significant (AUC=0.79) and not significantly different from the AUC obtained in the original validation study (AUC=0.81). Reliability (coefficient α) was 0.83, which is comparable to the 0.86 obtained in the original sample.
Results of the cross validation suggest that the psychometric parameters of the COMM are not based solely on unique characteristics of the initial validation sample. The COMM seems to be a reliable and valid screening tool to help detect current aberrant drug-related behavior among chronic pain patients.
当前阿片类药物滥用量表（COMM）是一种自我报告的衡量慢性疼痛患者在开阿片类药物治疗疼痛时出现异常药物相关行为风险的工具。它是为了补充阿片类药物滥用潜力的预测筛查工具，并提高临床医生定期评估患者阿片类药物滥用风险的能力而开发的。本研究的目的是用慢性非癌痛患者的样本对 COMM 进行交叉验证。
从美国 5 个疼痛管理中心招募了 226 名因疼痛而服用阿片类药物的参与者。参与者完成了 17 项 COMM 及一系列自我报告的量表。他们的主治医生对他们进行了评分，进行了尿液毒理学筛查，并根据异常药物行为指数进行了分类。
在这项交叉验证中，可靠性和预测有效性通过曲线下面积（AUC）进行测量，结果发现具有高度显著性（AUC=0.79），与原始验证研究中的 AUC（AUC=0.81）没有显著差异。可靠性（α系数）为 0.83，与原始样本中获得的 0.86 相当。
交叉验证的结果表明，COMM 的心理计量学参数不仅仅基于初始验证样本的独特特征。COMM 似乎是一种可靠且有效的筛查工具，可帮助检测慢性疼痛患者当前的异常药物相关行为。
