Test characteristics of shorter versions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for brief screening for problematic substance use in a population sample from Israel
Abstract Background Substance use is a leading cause of preventable morbidity and mortality worldwide. Population-wide screening for problematic substance use in primary health care may mitigate the serious health and socio-economic consequences of such use, but the standard Alcohol, Smoking and Sub...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13011-023-00566-7 |
| _version_ | 1797453853187112960 |
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| author | Dvora Shmulewitz Roi Eliashar Maor Daniel Levitin Shaul Lev-Ran |
| author_facet | Dvora Shmulewitz Roi Eliashar Maor Daniel Levitin Shaul Lev-Ran |
| author_sort | Dvora Shmulewitz |
| collection | DOAJ |
| description | Abstract Background Substance use is a leading cause of preventable morbidity and mortality worldwide. Population-wide screening for problematic substance use in primary health care may mitigate the serious health and socio-economic consequences of such use, but the standard Alcohol, Smoking and Substance Involvement Screening Test (ASSIST 3.1) may be too long for wide-scale screening. How well validated shorter versions (ASSIST-Lite, ASSIST-FC) perform in identifying those with ASSIST 3.1 problematic use in different settings is unclear. Methods General population Jewish adults in Israel (N = 2,474) responded to an online survey that included the ASSIST 3.1 and sociodemographics. Across substances (alcohol, tobacco, cannabis, sedatives, prescription stimulants, prescription painkillers), receiver operator characteristic curve analysis determined that ASSIST-FC scores performed better than ASSIST-Lite at identifying those with problematic use, and evaluated differential ASSIST-FC performance by gender or age. Test characteristics and agreement were evaluated for binary ASSIST-FC versions, with ASSIST 3.1 problematic use as the gold standard. Results ASSIST-FC scores showed high ability to identify ASSIST 3.1 problematic use, with minimal differences by gender or age. Binary ASSIST-FC (most substances: threshold 3+; alcohol: 5+) showed high specificity and positive predictive value, acceptable sensitivity, and good agreement. Conclusions The ASSIST-FC, which assesses frequency of use and other’s concerns about use, appears useful for very brief screening in primary care to identify patients who may benefit from intervention. Early identification of those at-risk may prevent more severe consequences and ultimately decrease the significant costs of problematic substance use on the individual and population level. |
| first_indexed | 2024-03-09T15:28:52Z |
| format | Article |
| id | doaj.art-09dd9ec58ad04971a363a220f9c44542 |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-03-09T15:28:52Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-09dd9ec58ad04971a363a220f9c445422023-11-26T12:22:09ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2023-10-0118111110.1186/s13011-023-00566-7Test characteristics of shorter versions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for brief screening for problematic substance use in a population sample from IsraelDvora Shmulewitz0Roi Eliashar1Maor Daniel Levitin2Shaul Lev-Ran3Israel Center on AddictionIsrael Center on AddictionIsrael Center on AddictionIsrael Center on AddictionAbstract Background Substance use is a leading cause of preventable morbidity and mortality worldwide. Population-wide screening for problematic substance use in primary health care may mitigate the serious health and socio-economic consequences of such use, but the standard Alcohol, Smoking and Substance Involvement Screening Test (ASSIST 3.1) may be too long for wide-scale screening. How well validated shorter versions (ASSIST-Lite, ASSIST-FC) perform in identifying those with ASSIST 3.1 problematic use in different settings is unclear. Methods General population Jewish adults in Israel (N = 2,474) responded to an online survey that included the ASSIST 3.1 and sociodemographics. Across substances (alcohol, tobacco, cannabis, sedatives, prescription stimulants, prescription painkillers), receiver operator characteristic curve analysis determined that ASSIST-FC scores performed better than ASSIST-Lite at identifying those with problematic use, and evaluated differential ASSIST-FC performance by gender or age. Test characteristics and agreement were evaluated for binary ASSIST-FC versions, with ASSIST 3.1 problematic use as the gold standard. Results ASSIST-FC scores showed high ability to identify ASSIST 3.1 problematic use, with minimal differences by gender or age. Binary ASSIST-FC (most substances: threshold 3+; alcohol: 5+) showed high specificity and positive predictive value, acceptable sensitivity, and good agreement. Conclusions The ASSIST-FC, which assesses frequency of use and other’s concerns about use, appears useful for very brief screening in primary care to identify patients who may benefit from intervention. Early identification of those at-risk may prevent more severe consequences and ultimately decrease the significant costs of problematic substance use on the individual and population level.https://doi.org/10.1186/s13011-023-00566-7ASSISTASSIST-FCProblematic substance useTest characteristicsPublic healthScreening |
| spellingShingle | Dvora Shmulewitz Roi Eliashar Maor Daniel Levitin Shaul Lev-Ran Test characteristics of shorter versions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for brief screening for problematic substance use in a population sample from Israel Substance Abuse Treatment, Prevention, and Policy ASSIST ASSIST-FC Problematic substance use Test characteristics Public health Screening |
| title | Test characteristics of shorter versions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for brief screening for problematic substance use in a population sample from Israel |
| title_full | Test characteristics of shorter versions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for brief screening for problematic substance use in a population sample from Israel |
| title_fullStr | Test characteristics of shorter versions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for brief screening for problematic substance use in a population sample from Israel |
| title_full_unstemmed | Test characteristics of shorter versions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for brief screening for problematic substance use in a population sample from Israel |
| title_short | Test characteristics of shorter versions of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for brief screening for problematic substance use in a population sample from Israel |
| title_sort | test characteristics of shorter versions of the alcohol smoking and substance involvement screening test assist for brief screening for problematic substance use in a population sample from israel |
| topic | ASSIST ASSIST-FC Problematic substance use Test characteristics Public health Screening |
| url | https://doi.org/10.1186/s13011-023-00566-7 |
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