Abstract
BackgroundSynthesis of psychometric properties of substance use measures to identify patterns of use and substance use disorders remains limited. To address this gap, we sought to systematically evaluate the psychometric properties of measures to detect substance use and misuse.MethodsWe conducted a systematic review and meta-analysis of literature on measures of substance classes associated with HIV risk (heroin, methamphetamine, cocaine, ecstasy, alcohol) that were published in English before June 2016 that reported at least one of the following psychometric outcomes of interest: internal consistency (alpha), test-retest/inter-rater reliability (kappa), sensitivity, specificity, positive predictive value, and negative predictive value. We used meta-analytic techniques to generate pooled summary estimates for these outcomes using random effects and hierarchical logistic regression models.ResultsFindings across 387 paper revealed that overall, 65% of pooled estimates for alpha were in the range of fair-to-excellent; 44% of estimates for kappa were in the range of fair-to-excellent. In addition, 69, 97, 37 and 96% of pooled estimates for sensitivity, specificity, positive predictive value, and negative predictive value, respectively, were in the range of moderate-to-excellent.ConclusionWe conclude that many substance use measures had pooled summary estimates that were at the fair/moderate-to-excellent range across different psychometric outcomes. Most scales were conducted in English, within the United States, highlighting the need to test and validate these measures in more diverse settings. Additionally, the majority of studies had high risk of bias, indicating a need for more studies with higher methodological quality.
Highlights
Synthesis of psychometric properties of substance use measures to identify patterns of use and substance use disorders remains limited
Illicit drug use disorders were attributed to 20 million disability-adjusted life years (DALYs) lost [4] while alcohol use disorders were attributed to 85 million Disability-adjusted life year (DALY) lost in 2012 [5]
Among people living with Human immunodeficiency virus (HIV) (PLWH), substance use disorders may lead to less optimal HIV care outcomes because of their associations with lower likelihood of being linked to HIV care, retained in care, receiving antiretroviral therapy (ART), having high ART adherence and lower likelihood of having an undetectable HIV viral load [9, 10, 16,17,18]
Summary
Synthesis of psychometric properties of substance use measures to identify patterns of use and substance use disorders remains limited. The number of people with drug use disorders was estimated at 62 million, while the number of individuals with alcohol use disorders was estimated at 100.4 million in 2016 [3]. Illicit drug use disorders were attributed to 20 million disability-adjusted life years (DALYs) lost [4] while alcohol use disorders were attributed to 85 million DALYs lost in 2012 [5]. Among people living with HIV (PLWH), substance use disorders may lead to less optimal HIV care outcomes because of their associations with lower likelihood of being linked to HIV care, retained in care, receiving antiretroviral therapy (ART), having high ART adherence and lower likelihood of having an undetectable HIV viral load [9, 10, 16,17,18]
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