A Brief Patient Self-administered Substance Use Screening Tool for Primary Care: Two-site Validation Study of the Substance Use Brief Screen (SUBS).
Background: Substance use screening is widely encouraged in health care settings, but the lack of a screening approach that fits easily into clinical workflows has restricted its broad implementation. The Substance Use Brief Screen (SUBS) was developed as a brief, self-administered instrument to ide...
| Publicado en: | American Journal of Medicine Vol. 128; no. 7; pp. 784.e9 - 784000000001 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Excerpta Medica Publishing Group
Jul2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109806183&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109806183 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00029343 AJM jtl: American Journal of Medicine issn: 00029343 maglogo: N pubinfo: dt: Jul2015 vid: 128 iid: 7 pid: 1688 pub: Excerpta Medica Publishing Group artinfo: ui: 109806183 NLM25770031 2013058914 10.1016/j.amjmed.2015.02.007 NLM25770031 PMC4475501 109806183 ppf: 784.e9 ppct: 1 formats: tig: atl: A Brief Patient Self-administered Substance Use Screening Tool for Primary Care: Two-site Validation Study of the Substance Use Brief Screen (SUBS). aug: au: McNeely, Jennifer Strauss, Shiela M Saitz, Richard Cleland, Charles M Palamar, Joseph J Rotrosen, John Gourevitch, Marc N sug: subj: Internet Utilization Health Screening Methods Primary Health Care Methods Self Report Substance Use Disorders Epidemiology Adolescence Adult Age Factors Alcoholism Epidemiology Ambulatory Care Facilities Confidence Intervals Female Human Incidence Male Middle Age Drug Therapy Statistics and Numerical Data Questionnaires Reproducibility of Results Risk Assessment Sensitivity and Specificity Sex Factors Smoking Epidemiology Street Drugs Adverse Effects Substance Use Disorders Diagnosis United States Urban Population Young Adult Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background: Substance use screening is widely encouraged in health care settings, but the lack of a screening approach that fits easily into clinical workflows has restricted its broad implementation. The Substance Use Brief Screen (SUBS) was developed as a brief, self-administered instrument to identify unhealthy use of tobacco, alcohol, illicit drugs, and prescription drugs. We evaluated the validity and test-retest reliability of the SUBS in adult primary care patients.Methods: Adults aged 18-65 years were enrolled from urban safety net primary care clinics to self-administer the SUBS using touch-screen tablet computers for a test-retest reliability study (n = 54) and a 2-site validation study (n = 586). In the test-retest reliability study, the SUBS was administered twice within a 2-week period. In the validation study, the SUBS was compared with reference standard measures, including self-reported measures and oral fluid drug tests. We measured test-retest reliability and diagnostic accuracy of the SUBS for detection of unhealthy use and substance use disorder for tobacco, alcohol, and drugs (illicit and prescription drug misuse).Results: Test-retest reliability was good or excellent for each substance class. For detection of unhealthy use, the SUBS had sensitivity and specificity of 97.8% (95% confidence interval [CI], 93.7-99.5) and 95.7% (95% CI, 92.4-97.8), respectively, for tobacco; and 85.2% (95% CI, 79.3-89.9) and 77.0% (95% CI, 72.6-81.1) for alcohol. For unhealthy use of illicit or prescription drugs, sensitivity was 82.5% (95% CI, 75.7-88.0) and specificity 91.1% (95% CI, 87.9-93.6). With respect to identifying a substance use disorder, the SUBS had sensitivity and specificity of 100.0% (95% CI, 92.7-100.0) and 72.1% (95% CI, 67.1-76.8) for tobacco; 93.5% (95% CI, 85.5-97.9) and 64.6% (95% CI, 60.2-68.7) for alcohol; and 85.7% (95% CI, 77.2-92.0) and 82.0% (95% CI, 78.2-85.3) for drugs. Analyses of area under the receiver operating curve (AUC) indicated good discrimination (AUC 0.74-0.97) for all substance classes. Assistance in completing the SUBS was requested by 11% of participants.Conclusions: The SUBS was feasible for self-administration and generated valid results in a diverse primary care patient population. The 4-item SUBS can be recommended for primary care settings that are seeking to implement substance use screening. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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