期刊
PEDIATRICS
卷 128, 期 1, 页码 E180-E192出版社
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2010-3727
关键词
substance abuse detection; screening; adolescent; emergency medical services
类别
资金
- Canadian Institutes of Health Research [200805KRS]
- Canadian Child Health Clinician Scientist Program in partnership
- Sick-Kids Foundation
- Child & Family Research Institute (British Columbia)
- Women & Children's Health Research Institute (Alberta)
- Manitoba Institute of Child Health
CONTEXT: Alcohol and other drug (AOD) misuse by youth is a significant public health concern. Unanticipated treatment for AOD-related morbidities is often sought in hospital emergency departments (EDs). Screening instruments that rapidly identify patients who require further diagnostic evaluation and/or brief intervention are critically important. OBJECTIVE: To summarize evidence on screening instruments that can assist emergency care clinicians in identifying AOD misuse in pediatric patients. METHODS: Fourteen electronic databases (including Medline, Embase, and PsycINFO) and reference screening were used. Psychometric and prospective diagnostic studies were selected if the instrument focused on detecting AOD misuse in patients aged 21 years or younger in the ED. Two reviewers independently assessed quality and extracted data. Validity and reliability data were collected for psychometric studies. Instrument performance was assessed by using sensitivity, specificity, and positive (LR+) and negative (LR-) likelihood ratios. Meta-analysis was not possible because of clinical and measurement heterogeneity. RESULTS: Of the 1545 references initially identified, 6 studies met inclusion criteria; these studies evaluated 11 instruments for universal or targeted screening of alcohol misuse. Instruments based on diagnostic criteria for AOD disorders were effective in detecting alcohol abuse and dependence (sensitivity: 0.88; specificity: 0.90; LR+ : 8.80) and cannabis use disorder (sensitivity: 0.96; specificity: 0.86; LR+: 6.83). CONCLUSIONS: On the basis of the current evidence, we recommend that emergency care clinicians use a 2-question instrument for detecting youth alcohol misuse and a 1-question instrument for detecting cannabis misuse. Additional research is required to definitively answer whether these tools should be used as targeted or universal screening approaches in the ED. Pediatrics 2011;128:e180-e192
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据