From the College of Public Health, Division of Health Services Management and Policy, Ohio State University, Columbus, OH (LJC, TMW, DJC); Nationwide Children's Hospital, Research Institute, Columbus (LJC, DJC); Kaiser Permanente Washington Health Research Institute, Seattle, WA (KAB, GTL); College of Medicine, Department of Pediatrics, Ohio State University, Columbus (DJC).
J Am Board Fam Med. 2019 Jul-Aug;32(4):550-558. doi: 10.3122/jabfm.2019.04.180284.
Brief substance use screening questions for tobacco, alcohol, cannabis, and other drugs need further validation in adolescents. In particular, optimal age-specific screening cut-points are not known, and no study has been large enough to evaluate screening questions for noncannabis illicit drug use.
Adolescent respondents to an annual national household survey were included (2008 to 2014; n = 169,986). Days of tobacco use in the past month, and days of alcohol, cannabis, other illicit drug use in the past year, were assessed as brief screens for tobacco dependence and DSM-IV alcohol (AUD), cannabis (CUD), and other illicit drug use disorders (DUD). Areas under receiver operating characteristics curves (AUCs), sensitivity and specificity were estimated separately by age group (12-15-, 16-17-, and 18-20-year-olds) and cut-points that maximized combined values of sensitivity and specificity were considered optimal.
The prevalence of tobacco dependence, AUD, CUD, and DUD was 5.8%, 7.1%, 4.5%, and 2.0%, respectively. AUCs ranged 0.84 to 0.99. The optimal cut-points for screening for tobacco dependence and DUDs was the same for all age groups: ≥1 day. The optimal cut-points for alcohol and cannabis varied by age: ≥3 days for 12-15-year-olds and ≥12 days for older adolescents.
Brief measures of past-year use, or past-month use for tobacco, accurately identified adolescents with problematic substance use. However, health systems should use age-specific screening cut-points for alcohol and cannabis to optimize screening performance.
简短的物质使用筛查问题，如烟草、酒精、大麻和其他药物，需要在青少年中进一步验证。特别是，特定年龄的最佳筛查切点尚不清楚，也没有研究足够大，以评估非大麻非法药物使用的筛查问题。
纳入了一项年度全国家庭调查的青少年受访者（2008 年至 2014 年；n=169986）。过去一个月吸烟天数，以及过去一年饮酒、大麻、其他非法药物使用天数，被评估为烟草依赖和 DSM-IV 酒精（AUD）、大麻（CUD）和其他非法药物使用障碍（DUD）的简短筛查。通过年龄组（12-15 岁、16-17 岁和 18-20 岁）分别估计接收者操作特征曲线（AUCs）、敏感性和特异性的面积，考虑到敏感性和特异性的综合值最大化的切点被认为是最佳切点。
烟草依赖、AUD、CUD 和 DUD 的患病率分别为 5.8%、7.1%、4.5%和 2.0%。AUCs 范围为 0.84 至 0.99。筛查烟草依赖和 DUD 的最佳切点在所有年龄组均相同：≥1 天。酒精和大麻的最佳切点因年龄而异：12-15 岁者为≥3 天，年龄较大者为≥12 天。
过去一年使用情况或过去一个月使用情况的简短测量可以准确识别有问题物质使用的青少年。然而，卫生系统应使用针对酒精和大麻的特定年龄筛查切点，以优化筛查性能。
