Schuckit M A, Irwin M, Howard T, Smith T
Veterans Administration Medical Center, San Diego, California 92161.
J Stud Alcohol. 1988 Jan;49(1):93-9. doi: 10.15288/jsa.1988.49.93.
Forty alcoholic inpatient men were used to evaluate the test-retest reliability and the validity of a new structured diagnostic interview. The Alcohol Research Center (ARC) Intake Interview was constructed from the Schedule of Affective Disorders and Schizophrenia (SADS) parts I and II and from the Diagnostic Interview Schedule family history section by extracting information on diagnoses most likely to be seen in alcoholic patients and by expanding the data set with questions relevant to alcohol and drug use. The test-retest reliability for patients' primary and secondary diagnoses included a kappa of 1.00 for the comparison of interviewers A and B (100% agreement) and of .76 for interviewers A and C. The validity of ARC Intake Interview patient diagnoses as compared to the SADS demonstrated an overall agreement between 91 and 100%. Reliabilities for labeling of families as positive or negative for specific illness in any first-degree relatives revealed a kappa of 1.00; validities on family diagnoses ranged from 77 to 100%, with the ARC Intake Interview identifying more illness in families than the SADS. Although further evaluation of the ARC Intake Interview is needed, this instrument is recommended to investigators attempting to evaluate the clinical course and treatment needs among alcoholics, especially those patients presenting with multiple diagnoses.
四十名男性酒精成瘾住院患者被用于评估一种新的结构化诊断访谈的重测信度和效度。酒精研究中心(ARC)的入院访谈是根据情感障碍与精神分裂症问卷(SADS)的第一部分和第二部分以及诊断访谈问卷的家族史部分构建而成,通过提取酒精成瘾患者中最可能出现的诊断信息,并增加与酒精和药物使用相关的问题来扩充数据集。患者原发性和继发性诊断的重测信度方面,访谈者A和B比较时的kappa值为1.00(一致性为100%),访谈者A和C比较时为0.76。与SADS相比,ARC入院访谈对患者诊断的效度显示总体一致性在91%至100%之间。对一级亲属中特定疾病的家族标记为阳性或阴性的信度显示kappa值为1.00;家族诊断的效度范围为77%至100%,ARC入院访谈在家族中识别出的疾病比SADS更多。尽管ARC入院访谈还需要进一步评估,但推荐该工具给试图评估酒精成瘾者临床病程和治疗需求的研究者,尤其是那些有多种诊断的患者。