Pilkonis Paul A, Yu Lan, Dodds Nathan E, Johnston Kelly L, Lawrence Suzanne M, Daley Dennis C
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United States.
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United States; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United States.
Drug Alcohol Depend. 2016 Apr 1;161:316-22. doi: 10.1016/j.drugalcdep.2016.02.014. Epub 2016 Feb 17.
The Patient-Reported Outcomes Measurement Information System (PROMIS) includes five item banks for alcohol use. There are limited data, however, regarding their validity (e.g., convergent validity, responsiveness to change). To provide such data, we conducted a prospective study with 225 outpatients being treated for substance abuse.
Assessments were completed shortly after intake and at 1-month and 3-month follow-ups. The alcohol item banks were administered as computerized adaptive tests (CATs). Fourteen CATs and one six-item short form were also administered from eight other PROMIS domains to generate a comprehensive health status profile. After modeling treatment outcome for the sample as a whole, correlates of outcome from the PROMIS health status profile were examined.
For convergent validity, the largest correlation emerged between the PROMIS alcohol use score and the Alcohol Use Disorders Identification Test (r=.79 at intake). Regarding treatment outcome, there were modest changes across the target problem of alcohol use and other domains of the PROMIS health status profile. However, significant heterogeneity was found in initial severity of drinking and in rates of change for both abstinence and severity of drinking during follow-up. This heterogeneity was associated with demographic (e.g., gender) and health-profile (e.g., emotional support, social participation) variables.
The results demonstrated the validity of PROMIS CATs, which require only 4-6 items in each domain. This efficiency makes it feasible to use a comprehensive health status profile within the substance use treatment setting, providing important prognostic information regarding abstinence and severity of drinking.
患者报告结局测量信息系统(PROMIS)包括五个酒精使用项目库。然而,关于它们的有效性(例如,收敛效度、对变化的反应性)的数据有限。为了提供此类数据,我们对225名接受药物滥用治疗的门诊患者进行了一项前瞻性研究。
在入院后不久以及1个月和3个月随访时完成评估。酒精项目库作为计算机自适应测试(CAT)进行施测。还从其他八个PROMIS领域施测了14个CAT和一个六项简表,以生成全面的健康状况概况。在对整个样本的治疗结果进行建模后,检查了PROMIS健康状况概况中结果的相关性。
为了评估收敛效度,PROMIS酒精使用得分与酒精使用障碍识别测试之间的相关性最大(入院时r = 0.79)。关于治疗结果,酒精使用这一目标问题以及PROMIS健康状况概况的其他领域均有适度变化。然而,在饮酒的初始严重程度以及随访期间戒酒和饮酒严重程度的变化率方面发现了显著的异质性。这种异质性与人口统计学(例如,性别)和健康概况(例如,情感支持、社会参与)变量相关。
结果证明了PROMIS CAT的有效性,每个领域仅需施测4 - 6个项目。这种高效性使得在药物使用治疗环境中使用全面的健康状况概况成为可能,为戒酒和饮酒严重程度提供重要的预后信息。