From the Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Centre on Drug Policy Evaluation, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Epidemiology. 2022 Mar 1;33(2):287-294. doi: 10.1097/EDE.0000000000001443.
Studies of people who inject drugs (PWID) commonly use questionnaires to determine whether participants are currently, or have recently been, on opioid agonist treatment for opioid use disorder. However, these previously unvalidated self-reported treatment measures may be susceptible to inaccurate reporting.
We linked baseline questionnaire data from 521 PWID in the Ontario integrated Supervised Injection Services cohort in Toronto (November 2018-March 2020) with record-level health administrative data. We assessed the validity (sensitivity, specificity, positive and negative predictive value [PPV and NPV]) of self-reported recent (in the past 6 months) and current (as of interview) opioid agonist treatment with methadone or buprenorphine-naloxone relative to prescription dispensation records from a provincial narcotics monitoring system, considered the reference standard.
For self-reported recent opioid agonist treatment, sensitivity was 78% (95% CI = 72, 83), specificity was 90% (95% CI = 86, 94), PPV was 90% (95% CI = 85, 93), and NPV was 79% (95% CI = 74, 84). For self-reported current opioid agonist treatment, sensitivity was 84% (95% CI = 78, 90), specificity was 87% (95% CI = 83, 91), PPV was 74% (95% CI = 67, 81), and NPV was 93% (95% CI = 89, 95).
Self-reported opioid agonist treatment measures were fairly accurate among PWID, with some exceptions. Inaccurate recall due to a lengthy lookback window may explain underreporting of recent treatment, whereas social desirability bias may have led to overreporting of current treatment. These validation data could be used in future studies of PWID to adjust for misclassification in similar self-reported treatment measures.
研究注射吸毒者（PWID）的常见方法是使用问卷来确定参与者是否正在或最近接受阿片类药物激动剂治疗阿片类药物使用障碍。然而，这些以前未经验证的自我报告的治疗措施可能容易出现不准确的报告。
我们将来自多伦多安大略省综合监督注射服务队列的 521 名 PWID 的基线问卷数据（2018 年 11 月至 2020 年 3 月）与记录级别的健康行政数据相关联。我们评估了自我报告的最近（过去 6 个月内）和当前（截至访谈时）使用美沙酮或丁丙诺啡-纳洛酮的阿片类药物激动剂治疗的有效性（敏感性、特异性、阳性和阴性预测值[PPV 和 NPV]）与省级麻醉品监测系统的处方配药记录进行比较，后者被认为是参考标准。
对于自我报告的近期阿片类药物激动剂治疗，敏感性为 78%（95%CI=72,83），特异性为 90%（95%CI=86,94），PPV 为 90%（95%CI=85,93），NPV 为 79%（95%CI=74,84）。对于自我报告的当前阿片类药物激动剂治疗，敏感性为 84%（95%CI=78,90），特异性为 87%（95%CI=83,91），PPV 为 74%（95%CI=67,81），NPV 为 93%（95%CI=89,95）。
在 PWID 中，自我报告的阿片类药物激动剂治疗措施具有相当的准确性，但也存在一些例外。由于回顾窗口较长，可能导致最近治疗的漏报，记忆不准确。而社交期望偏差可能导致当前治疗的过度报告。这些验证数据可用于未来 PWID 的研究中，以调整类似的自我报告治疗措施中的分类错误。
