Department of Community Health Systems, University of California San Francisco, 25 Van Ness Avenue, Suite 500, San Francisco, CA, 94102, USA.
Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA.
BMC Med Res Methodol. 2020 May 7;20(1):106. doi: 10.1186/s12874-020-00963-7.
Synthesis of psychometric properties of substance use measures to identify patterns of use and substance use disorders remains limited. To address this gap, we sought to systematically evaluate the psychometric properties of measures to detect substance use and misuse.
We conducted a systematic review and meta-analysis of literature on measures of substance classes associated with HIV risk (heroin, methamphetamine, cocaine, ecstasy, alcohol) that were published in English before June 2016 that reported at least one of the following psychometric outcomes of interest: internal consistency (alpha), test-retest/inter-rater reliability (kappa), sensitivity, specificity, positive predictive value, and negative predictive value. We used meta-analytic techniques to generate pooled summary estimates for these outcomes using random effects and hierarchical logistic regression models.
Findings across 387 paper revealed that overall, 65% of pooled estimates for alpha were in the range of fair-to-excellent; 44% of estimates for kappa were in the range of fair-to-excellent. In addition, 69, 97, 37 and 96% of pooled estimates for sensitivity, specificity, positive predictive value, and negative predictive value, respectively, were in the range of moderate-to-excellent.
We conclude that many substance use measures had pooled summary estimates that were at the fair/moderate-to-excellent range across different psychometric outcomes. Most scales were conducted in English, within the United States, highlighting the need to test and validate these measures in more diverse settings. Additionally, the majority of studies had high risk of bias, indicating a need for more studies with higher methodological quality.
综合物质使用测量的心理测量特性以识别使用模式和物质使用障碍仍然有限。为了解决这一差距，我们试图系统地评估用于检测物质使用和误用的测量方法的心理测量特性。
我们对发表在英语文献中的、与艾滋病毒风险相关的物质类别（海洛因、冰毒、可卡因、摇头丸、酒精）的测量方法进行了系统评价和元分析，这些文献发表于 2016 年 6 月之前，并报告了至少以下感兴趣的心理测量结果之一：内部一致性（alpha）、重测/评分者间可靠性（kappa）、敏感性、特异性、阳性预测值和阴性预测值。我们使用元分析技术，使用随机效应和分层逻辑回归模型，对这些结果的汇总估计值进行了汇总。
在 387 篇论文中发现，总体而言，alpha 的汇总估计值中，65%处于良好至优秀的范围内；kappa 的汇总估计值中，44%处于良好至优秀的范围内。此外，敏感性、特异性、阳性预测值和阴性预测值的汇总估计值中，分别有 69%、97%、37%和 96%处于中度至优秀的范围内。
我们的结论是，许多物质使用测量方法的汇总估计值在不同的心理测量结果中处于良好/中度至优秀的范围内。大多数量表都是用英语在美国进行的，这突出表明需要在更多样化的环境中测试和验证这些措施。此外，大多数研究的偏倚风险较高，表明需要更多具有更高方法学质量的研究。
