Mammen Kristie, Mills Llewellyn, Deacon Rachel M, Bruno Raimondo, Dunlop Adrian, Holmes Jennifer, Luksza Jennifer, Shakeshaft Anthony, Farrell Michael, Lintzeris Nicholas
Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.
NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia.
Drug Alcohol Rev. 2022 Jan;41(1):106-113. doi: 10.1111/dar.13346. Epub 2021 Jun 29.
The Australian Treatment Outcomes Profile (ATOP) is a brief instrument that measures self-reported substance use, health, and wellbeing in the previous 28 days for people in alcohol and other drug treatment. Previous studies have established the concurrent validity, inter-rater, and test-retest reliability of the tool. The current study sought to identify recommended cutoff scores for ATOP items for psychological health, physical health and quality of life that identify clients reporting clinically significant problems warranting further assessment and/or intervention, compared to cutoffs used by 'gold-standard' measures for these domains.
Clients attending for treatment for problems with opioid (n = 144) or alcohol use (n = 134) completed the ATOP and comparison standardised questionnaires (Kessler-10, Short Form Survey 12 and the Personal Wellbeing Index) with a researcher. Receiver operating characteristics analysis, along with clinician perspectives, were used to recommend cutoff scores for ATOP items indicative of clinically significant problems.
A cutoff score of 5 or less out of 10 was identified as an optimal pragmatic cutoff for ATOP items relating to psychological health, physical health and quality of life items with regards to balancing sensitivity, specificity, and application in a treatment setting.
The recommended clinical cutoffs will support clinicians and treatment services to identify clients who require further assessment and follow up for their psychological health, physical health and quality of life. The current study provides further evidence for the utility of the ATOP for individual clinical review, service planning and research.
澳大利亚治疗结果概况（ATOP）是一种简短的工具，用于测量接受酒精和其他药物治疗的人群在过去28天内自我报告的物质使用情况、健康状况和幸福感。先前的研究已经确立了该工具的同时效度、评分者间信度和重测信度。本研究旨在确定ATOP中关于心理健康、身体健康和生活质量项目的推荐临界值，以识别那些报告有临床显著问题、需要进一步评估和/或干预的客户，并与这些领域的“金标准”测量所使用的临界值进行比较。
因阿片类药物问题（n = 144）或酒精使用问题（n = 134）前来接受治疗的客户与一名研究人员一起完成了ATOP以及比较标准化问卷（凯斯勒10项量表、简短健康调查问卷12项量表和个人幸福感指数）。采用受试者工作特征分析以及临床医生的观点，为ATOP中表明存在临床显著问题的项目推荐临界值。
就平衡敏感性、特异性以及在治疗环境中的应用而言，10分制中5分及以下的临界值被确定为ATOP中与心理健康、身体健康和生活质量项目相关的最佳实用临界值。
推荐的临床临界值将有助于临床医生和治疗服务机构识别那些在心理健康、身体健康和生活质量方面需要进一步评估和随访的客户。本研究为ATOP在个体临床评估、服务规划和研究中的效用提供了进一步的证据。
