Challenges of Reliability and Validity in the Identification and Monitoring of Emerging Drug Trends

Abstract

There is increasing pressure on drug monitoring systems to achieve earlier detection and greater precision in reporting of emerging drug use trends. Such systems typically operate in settings where government interest and the drug use trends themselves can be fluid. To achieve the goal of informing timely policy and practice responses in this environment, drug use monitoring systems must be flexible and responsive, as well as reliable and valid. This paper explores three interrelated areas relevant to trend monitoring that can benefit from a clearer focus in terms of increasing validity and reliability: the research paradigm to which systems adhere; the selection of sources or drug use indicators utilized by systems; and the process of analysis used by systems to ensure valid results. The reliability and validity of currently utilized drug use related indicators is discussed, with a focus on the validity of data sources as measures of emerging drug use trends. The relevance and utility of current descriptives such as “lagged” and “leading edge” indicators are assessed. Five dimensions, against which the validity of drug use indicators may be assessed in a trend-monitoring context are proposed as an alternative. Faced with a lack of clear conceptual frameworks underpinning and driving monitoring systems, it is argued that a pragmatic research paradigm can be adopted as a basis for guiding selection of indicators and helping to make explicit the concurrent or supplementary triangulation and analysis procedures on which valid results are necessarily founded. The current trend of using triangulation as the primary means of ensuring the validity of systems is critically reviewed and a challenge is issued to the field to make the analysis process more overt. No external funding was received for this article.