Dataset Information

Discriminative validity of a substance use symptom checklist for moderate-severe DSM-5 cannabis use disorder (CUD) in primary care settings.

ABSTRACT:

Background

The prevalence of cannabis use disorder (CUD) is increasing in the US and primary care providers need tools to identify patients with moderate-severe CUD to facilitate treatment. A single-item screen for cannabis (SIS-C) has outstanding discriminative validity for CUD. However, because the prevalence of moderate-severe CUD is typically low, the probability that an average patient who screens positive for daily cannabis has moderate-severe cannabis use disorder is low, making follow-up assessment important.

Methods

This study reports the discriminative validity of a DSM-5 Substance Use Symptom Checklist ("Checklist") for moderate-severe CUD among 498 primary care patients who reported daily cannabis use on the SIS-C. We evaluated the performance of the Checklist (score 0-11) completed during routine care, compared to ≥4 DSM-5 CUD symptoms (moderate-severe CUD) on the Composite International Diagnostic Interview Substance Abuse Module from a confidential survey (reference standard). We estimated areas under receiver operating curve (AUROC), sensitivities, specificities, and post-test probabilities.

Results

Of 498 eligible patients, 17 % met diagnostic criteria for moderate-severe CUD. The Checklist's AUROC for moderate-severe CUD was 0.77 (95 % CI: 0.71-0.83), and Checklist scores of 1-2 balanced sensitivity and specificity. Among patients from a population with average prevalence of CUD before screening (~6 % prevalence) and daily use on the SIS-C, a Checklist score of 3 indicated a post-test probability of 82.1 %.

Conclusion

Overall performance of the Checklist was good and the high specificity made it useful for identifying patients likely to have moderate-severe CUD among those at average risk.

SUBMITTER: Hamilton LK

PROVIDER: S-EPMC11326943 | biostudies-literature | 2024 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Discriminative validity of a substance use symptom checklist for moderate-severe DSM-5 cannabis use disorder (CUD) in primary care settings.

Hamilton Leah K LK Bradley Katharine A KA Matson Theresa E TE Lapham Gwen T GT

Drug and alcohol dependence reports 20240715

<h4>Background</h4>The prevalence of cannabis use disorder (CUD) is increasing in the US and primary care providers need tools to identify patients with moderate-severe CUD to facilitate treatment. A single-item screen for cannabis (SIS-C) has outstanding discriminative validity for CUD. However, because the prevalence of moderate-severe CUD is typically low, the probability that an average patient who screens positive for daily cannabis has moderate-severe cannabis use disorder is low, making f ...[more]

PMID: 39156656

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Dataset Information

Discriminative validity of a substance use symptom checklist for moderate-severe DSM-5 cannabis use disorder (CUD) in primary care settings.

Background

Methods

Results

Conclusion

Publications

Discriminative validity of a substance use symptom checklist for moderate-severe DSM-5 cannabis use disorder (CUD) in primary care settings.

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