Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia (SC); Centre for Academic Primary Care, Bristol Medical School, University of Bristol, UK (SC, DK); Department of Health Sciences, University of York, UK (JM).
J Addict Med. 2018 Nov/Dec;12(6):442-446. doi: 10.1097/ADM.0000000000000429.
There are several brief screening tools for gambling that possess promising psychometric properties, but have uncertain utility in generalist healthcare environments which prioritize prevention and brief interventions. This study describes an examination of the National Opinion Research Centre Diagnostic and Statistical Manual of Mental Disorders Screen for Gambling Problems (NODS-CLiP), in comparison with the Problem Gambling Severity Index (PGSI), when used to operationalize gambling problems across a spectrum of severity.
Data were obtained from 1058 primary care attendees recruited from 11 practices in England who completed various measures including the NODS-CLiP and PGSI. The performance of the former was defined by estimates of sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs), when PGSI indicators of problem gambling (5+) and any gambling problems (1+), respectively, were reference standards.
The NODS-CLiP demonstrated perfect sensitivity for problem gambling, along with high specificity and a NPV, but a low PPV. There was much lower sensitivity when the indicator of any gambling problems was the reference standard, with capture rates indicating only 20% of patients exhibiting low to moderate severity gambling problems (PGSI 1-4) were identified by the NODS-CLiP.
The NODS-CLiP performs well when identifying severe cases of problem gambling, but lacks sensitivity for less severe problems and may be unsuitable for settings which prioritize prevention and brief interventions. There is a need for screening measures which are sensitive across the full spectrum of risk and severity, and can support initiatives for improving identification and responses to gambling problems in healthcare settings such as primary care.
有几种简短的赌博筛查工具具有有前途的心理测量学特性，但在优先预防和简短干预的全科医疗环境中的效用不确定。本研究描述了对国家意见研究中心《精神障碍诊断和统计手册》赌博问题筛查（NODS-CLiP）的检查，与赌博严重程度指数（PGSI）相比，当用于对一系列严重程度的赌博问题进行操作化时。
数据来自从英格兰的 11 家诊所招募的 1058 名初级保健就诊者，他们完成了各种措施，包括 NODS-CLiP 和 PGSI。前者的性能通过估计敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）来定义，当 PGSI 指示的赌博问题（5+）和任何赌博问题（1+）分别为参考标准时。
NODS-CLiP 对赌博问题具有完美的敏感性，特异性和 NPV 很高，但 PPV 较低。当任何赌博问题的指标是参考标准时，敏感性要低得多，捕获率表明只有 20%表现出低至中度严重赌博问题（PGSI 1-4）的患者被 NODS-CLiP 识别。
NODS-CLiP 在识别严重的赌博问题方面表现良好，但对较轻的问题缺乏敏感性，可能不适合优先预防和简短干预的环境。需要具有敏感性的筛查措施，以涵盖整个风险和严重程度范围，并能够支持改善初级保健等医疗保健环境中识别和应对赌博问题的举措。
