What is the prevalence of drug use in the general population? Simulating underreported and unknown use for more accurate national estimates.

What is the prevalence of drug use in the general population? Simulating underreported and unknown use for more accurate national estimates.
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DOI:
10.1016/j.annepidem.2021.12.013
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发表时间:
2022-04
影响因子:
5.6
通讯作者:
--
中科院分区:
医学3区
文献类型:
--
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概述一种方法,通过纠正少报和未知药物使用的调查数据,获得更准确的美国一般人群药物使用估计。我们模拟了一个人口(n = 100,000),反映了2018年美国社区调查中美国成年人口的人口统计数据。在这一人群中,我们通过使用可获得的漏报估计,模拟了过去一个月大麻和可卡因使用的“真实”和自我报告的流行程度。我们将我们的算法应用于模拟人口的样本,以纠正自我报告的估计并恢复“真实”的人口患病率,验证我们的方法。我们将同样的方法应用于2018年全国药物使用和健康调查(NSDUH)数据,以产生一系列低报修正的估计数。模拟自我报告敏感性因药物和采样方法而异(大麻:77.6%-78.5%,可卡因:14.3%-22.1%)。在重复的样本中,平均校正患病率(通过将自我报告的患病率除以估计的敏感性计算)非常接近模拟的“真实”患病率。应用我们的算法大大提高了2018年NSDUH的估计(自我报告:大麻= 10.5%,可卡因= 0.8%;修正:大麻= 15.6%-16.6%,可卡因= 2.7%-5.5%)。使用一种简单的方法可以纠正国家药物使用流行率估计的漏报。然而,这种方法的有效应用需要准确的数据,在美国一般人群中错误分类的程度和相关关系。
To outline a method for obtaining more accurate estimates of drug use in the United States (US) general population by correcting survey data for underreported and unknown drug use. We simulated a population (n = 100,000) reflecting the demographics of the US adult population per the 2018 American Community Survey. Within this population, we simulated the “true” and self-reported prevalence of past-month cannabis and cocaine use by using available estimates of underreporting. We applied our algorithm to samples of the simulated population to correct self-reported estimates and recover the “true” population prevalence, validating our approach. We applied this same method to 2018 National Survey on Drug Use and Health (NSDUH) data to produce a range of underreporting-corrected estimates. Simulated self-report sensitivities varied by drug and sampling method (cannabis: 77.6%–78.5%, cocaine: 14.3%–22.1%). Across repeated samples, mean corrected prevalences (calculated by dividing self-reported prevalence by estimated sensitivity) closely approximated simulated “true” prevalences. Applying our algorithm substantially increased 2018 NSDUH estimates (self-report: cannabis = 10.5%, cocaine = 0.8%; corrected: cannabis = 15.6%–16.6%, cocaine = 2.7%–5.5%). National drug use prevalence estimates can be corrected for underreporting using a simple method. However, valid application of this method requires accurate data on the extent and correlates of misclassification in the general US population.
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