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A two-item conjoint screen for alcohol and other drug problems
R L Brown1, T Leonard, L A Saunders
1Department of Family Medicine, University of Wisconsin-Madsion Medical School, 53715, USA.
The Journal of the American Board of Family Practice
|April 21, 2001
Summary
A new two-item conjoint screen (TICS) effectively identifies alcohol and other drug use disorders in primary care patients. This brief screening tool demonstrates high sensitivity and specificity for detecting substance use disorders in adults.
Area of Science:
- Addiction Medicine
- Primary Care Screening
- Diagnostic Validity
Background:
- Nonmedical drug use is prevalent, yet current screening tools primarily focus on alcohol.
- There is a need for validated screening instruments for broader substance use disorders in primary care settings.
Purpose of the Study:
- To evaluate the criterion validity of a two-item conjoint screen (TICS) for alcohol and other drug abuse or dependence.
- To assess the TICS's effectiveness in a primary care patient population.
Main Methods:
- A split-sample design was used with primary care patients aged 18-59.
- Patients responded to screening items developed from focus groups.
- The DSM-III-R criteria for substance use disorders, assessed via the Composite International Diagnostic Interview-Substance Abuse Module, served as the criterion standard.
Main Results:
- The TICS achieved nearly 80% sensitivity and specificity in detecting current substance use disorders.
- The screen was particularly effective for identifying polysubstance use disorders.
- A dose-response relationship was observed, with higher numbers of positive responses correlating with increased likelihood of a substance use disorder.
Conclusions:
- The two-item conjoint screen (TICS) is a valid and efficient tool for detecting current alcohol or other drug problems in primary care.
- These two questions can be easily integrated into routine clinical interviews for young and middle-aged adults.