Bonn-Miller Marcel O, Heinz Adrienne J, Smith Everett V, Bruno Raimondo, Adamson Simon
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California.
National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California.
Cannabis Cannabinoid Res. 2016 Dec 1;1(1):252-261. doi: 10.1089/can.2016.0022. eCollection 2016.
Rates of cannabis use disorder (CUD) among vulnerable populations have increased in recent years, highlighting a need to equip providers with an efficient screening tool. A short form of the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) was developed by using item response theory and traditional statistical methods, with data from two community samples of cannabis users representing two countries. Four item selection methods (Rasch regression, test characteristic curve, logistic regression, discriminant function analysis) were employed to identify the optimal three-item shortened version. The diagnostic ability of the short form was evaluated by using receiver operating characteristic curves. Using a cut score of 2, the 3-item CUDIT-Short Form (CUDIT-SF; reliability alpha=0.66, Sample 1; 0.80, Sample 2) identified 78.26% of participants in Sample 1 and 78.31% of participants in Sample 2 who met DSM-5 criteria for CUD, with 98% agreement in Sample 1 and 93% agreement in Sample 2 with the full CUDIT-R on CUD classifications using a cut score of 13. Specificity was 76.70 and 78.00 in Samples 1 and 2, respectively. The CUDIT-SF may be useful in busy clinical settings for a stepwise screening. Further validation of this shortened version with larger samples and in different settings is warranted.
近年来,弱势群体中大麻使用障碍(CUD)的发生率有所上升,这凸显了为医疗服务提供者配备高效筛查工具的必要性。利用项目反应理论和传统统计方法,基于来自代表两个国家的大麻使用者的两个社区样本的数据,开发了大麻使用障碍识别测试修订版(CUDIT-R)的简短形式。采用四种项目选择方法(拉施回归、测试特征曲线、逻辑回归、判别函数分析)来确定最佳的三项简短版本。通过使用受试者工作特征曲线来评估简短形式的诊断能力。使用2分的临界值,三项CUDIT简短形式(CUDIT-SF;信度α=0.66,样本1;0.80,样本2)识别出样本1中78.26%的参与者和样本2中78.31%的参与者符合DSM-5的CUD标准,在样本1中一致性为98%,在样本2中使用13分的临界值时与完整的CUDIT-R在CUD分类上的一致性为93%。样本1和样本2的特异性分别为76.70和78.00。CUDIT-SF在繁忙的临床环境中进行逐步筛查可能有用。需要在更大样本和不同环境中对这个简短版本进行进一步验证。