Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, United States; VA Boston Healthcare System, Boston, MA, 02301, United States.
Merrill Palmer Skillman Institute and Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, 48202, United States.
Drug Alcohol Depend. 2019 Dec 1;205:107651. doi: 10.1016/j.drugalcdep.2019.107651. Epub 2019 Oct 21.
The purpose of this study is to evaluate five self-report, non-proprietary questionnaires in the identification of substance use disorders [including alcohol, cannabis, opioids, and stimulants] among pregnant women.
A total of 1220 pregnant women completed the NIDA Quick Screen, CRAFFT, Substance Use Risk Profile-Pregnancy (SURP-P), Wayne Indirect Drug Use Questionnaire (WIDUS), and the 5 Ps, as well as the MINI diagnostic interview for substance use disorders, which served as the reference standard. Measures of merit calculated for each screener included sensitivity, specificity, accuracy, and area under the receiver operating curve (AUROC).
The participants were socioeconomically diverse, with a mean age of 29 years. Over 15% met diagnostic criteria for a substance use disorder. AUROCS for identifying any substance use disorder (including alcohol) ranged from a high of 0.75 for the CRAFFT (95% CI = 0.72-79) and 0.74 for the SURP-P (95% CI = 0.71-.78) to a low of 0.62 for the NIDA Quick Screen (95% CI = 0.59-.65). Overall accuracy of most tested measures was higher for identification of alcohol use disorders than for other substance use disorders (e.g., AUROCs for the CRAFFT and SURP-P for identifying alcohol use disorders were 0.78 and 0.77, respectively).
The CRAFFT and SURP-P showed modest ability to identify substance use disorders among pregnant women. Future research is needed to develop an ideal questionnaire set in the complicated societal context which includes increasing rates of use and potential sanction.
本研究旨在评估五种自我报告的非专有问卷，以识别孕妇的物质使用障碍[包括酒精、大麻、阿片类药物和兴奋剂]。
共有 1220 名孕妇完成了 NIDA 快速筛查、CRAFFT、妊娠物质使用风险概况（SURP-P）、韦恩间接药物使用问卷（WIDUS）和 5Ps，以及用于物质使用障碍的 MINI 诊断访谈，作为参考标准。为每个筛选器计算的衡量标准包括敏感性、特异性、准确性和接收器操作特征曲线下的面积 (AUROC)。
参与者的社会经济状况多样，平均年龄为 29 岁。超过 15%的人符合物质使用障碍的诊断标准。用于识别任何物质使用障碍（包括酒精）的 AUROCS 范围从 CRAFFT 的 0.75（95%CI=0.72-79）和 SURP-P 的 0.74（95%CI=0.71-.78）的高位到 NIDA 快速筛查的 0.62（95%CI=0.59-.65）的低位。大多数测试措施的整体准确性对于识别酒精使用障碍高于其他物质使用障碍（例如，CRAFFT 和 SURP-P 用于识别酒精使用障碍的 AUROCs 分别为 0.78 和 0.77）。
CRAFFT 和 SURP-P 显示出在孕妇中识别物质使用障碍的适度能力。需要进一步研究以在包括使用和潜在制裁增加的复杂社会背景下开发理想的问卷集。
