Classification of Substance Use Severity and Treatment Outcomes: NIDA CTN Studies

物质使用严重程度和治疗结果的分类：NIDA CTN 研究

• 批准号: 7762506
• 负责人: Li-Tzy Wu
• 金额: $ 30.2万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7762506
• 关键词: Address; Alcohol or Other Drugs use; Algorithms; Area; Beck depression inventory; Biological; Classification; Clinical; Clinical Trials Network; Cultural Characteristics; DSM-V; Data; Data Analyses; Data Files; Data Set; Diagnosis; Diagnostic; Diagnostic and Statistical Manual; Drug Addiction; Drug usage; Equipment and supply inventories; Ethnic Origin; Ethnic group; Foundations; Frequencies; Future; Gender; HIV; Hybrids; Individual; Measurement; Measures; Mediator of activation protein; Mental Health; Methods; Modeling; National Institute of Drug Abuse; Outcome; Participant; Patient Self-Report; Pattern; Phase; Probability; Quality of life; Race; Randomized; Randomized Clinical Trials; Research; Risk; Risk Behaviors; SF-36; Severities; Sex Characteristics; Solid; Symptoms; Treatment outcome; Work; addiction; demographics; depression; design; diagnosis quality; follow-up; health related quality of life; improved; indexing; insight; instrument; meetings; programs; psychological distress; public health relevance; racial and ethnic; racial and ethnic disparities; racial/ethnic difference; response; sex; statistics; theories; treatment trial

DESCRIPTION (provided by applicant): This R21/R33 application is in response to RFA-DA-09-020. It seeks support to address one research area recommended by this RFA "Secondary data analyses of multiple trials in the NIDA Clinical Trials Network (CTN)." By capitalizing on the CTN's wealth of multisite treatment data from multiple trials, we seek to, in the R21 phase (Year 1), 1) identify and create analyzable flat data files from the raw trial data (stacked format), 2) generate study variables and codebooks by programming scoring algorithms for multiple standardized clinical instruments, 3) evaluate the extent of missing data, and 4) examine baseline clinical profiles (substance use and diagnoses, mental health, and quality of life) of trial participants by gender and race/ethnicity in order to guide the R33 phase of work. In the R33 phase (Years 2-4), we plan to evaluate the construct, concurrent, and predictive validity of categorical and dimensional models of substance use diagnoses. The multisite CTN trials present an unparalleled, excellent opportunity to explore and evaluate these clinically and scientifically important issues directly related to treatment outcomes and to the emerging Diagnostic and Statistical Manual Version-IV (DSM-V). Study Aims for R33 are to 1) investigate measurement equivalence of DSM-IV diagnostic questions by gender and race/ethnicity, 2) evaluate the construct and concurrent validity of DSM-IV substance use diagnoses using categorical, dimensional, and integrated hybrid models of diagnostic classification, 3) determine empirically defined drug dependence subtypes (an integrated hybrid model) in predicting subsequent outcomes and to explore the mediator and moderators of the associations, and 4) evaluate empirically-defined comorbid drug dependence subtypes in predicting subsequent outcomes and to explore the mediator and moderators of the associations. Gender/sex differences will be examined in all analyses either through stratified analyses or the inclusions of interaction terms as appropriate. PUBLIC HEALTH RELEVANCE: Randomized clinical trials dominate treatment research today. Findings from the proposed study will make unique contributions to randomized addiction treatment research. They will help inform gender and racial/ethnic differences in the clinical profiles of substance use diagnoses, the quality and clinical utility of self-report diagnostic measures, interpretations of study results within the CTN, and future designs and analyses of addiction treatment trials.

描述(申请人提供)：本R21/R33申请是对RFA-DA-09-020的回应。它寻求支持，以解决RFA推荐的一个研究领域：NIDA临床试验网络(CTN)中的多个试验的辅助数据分析。通过利用CTN来自多个试验的丰富的多点治疗数据，我们寻求在R21阶段(第1年)，1)从原始试验数据(堆叠格式)识别并创建可分析的平面数据文件，2)通过为多个标准化临床仪器编程评分算法来生成研究变量和代码簿，3)评估数据缺失的程度，以及4)按性别和种族/民族检查试验参与者的基线临床概况(物质使用和诊断、心理健康和生活质量)，以指导R33阶段的工作。在R33阶段(2-4年)，我们计划评估物质使用诊断的分类模型和维度模型的结构、并发和预测有效性。多点CTN试验提供了一个无与伦比的绝佳机会，可以探索和评估这些与治疗结果和新兴的诊断和统计手册第四版(DSM-V)直接相关的临床和科学上的重要问题。R33的研究目的是1)按性别和种族/民族调查DSM-IV诊断问题的测量等价性，2)使用分类、维度和综合诊断分类混合模型评估DSM-IV物质使用诊断的结构和同时有效性，3)确定经验定义的药物依赖亚型(综合混合模型)预测后续结果，并探索关联的中介和调节因素，以及4)评估经验定义的共病药物依赖亚型预测后续结果，并探索关联的中介和调节因素。将通过分层分析或酌情纳入互动术语，在所有分析中审查性别/性别差异。 公共卫生相关性：随机临床试验在当今的治疗研究中占据主导地位。拟议中的研究结果将对随机成瘾治疗研究做出独特的贡献。它们将有助于了解药物使用诊断的临床概况中的性别和种族/族裔差异，自我报告诊断措施的质量和临床效用，CTN内对研究结果的解释，以及成瘾治疗试验的未来设计和分析。