Shortening the SOAPP-R: Computer-based opioid risk assessment

描述（由申请人提供）：疼痛患者筛选和阿片类药物评估-修订版（SOAPP-R）是一份24项问卷，已被验证为阿片类药物滥用风险的衡量标准。虽然之前的研究已经将SOAPP-R与其他评估在灵敏度和特异性方面进行了比较，但筛选器目前仅以纸笔形式提供。此外，对于某些受访者，特别是健康状况不佳的人和阅读理解有困难的人来说，这可能太长了。因此，需要更短版本的SOAPP-R，以保持足够的灵敏度和特异性。拟议中的研究代表了通过为更短的基于计算机的仪器版本提供“原理证明”来填补这一空白的基本第一步。这些计算机版本利用中期分析（在评估过程中进行的计算），按个人答复者的需要定制调查表。可定制的程序进行研究，包括削减，随机削减，和决策树，所有这些都已成功地应用于其他领域的评估。此外，还将编制SOAPP-R的静态（不可定制）简表，供没有能力实施计算机问卷的从业人员使用。拟议的研究的第一个目标是开发一个计算机程序，执行和评估所有程序（削减，随机削减，决策树，简短的形式，并在一个给定的数据集的全长SOAPP-R）。对程序的评价将包括与分类准确性有关的统计数据（例如，敏感性和特异性）以及与答卷人负担有关的统计数据（例如，给药项目数的平均值和标准偏差）。拟议研究的第二个目标是使用428名接受全长SOAPP-R的个体的数据集比较上述程序，并进行随访，以确定他们是否参与了异常的药物相关行为。通过异常药物行为指数（ADBI）进行随访测定，ADBI是一种通过结构化访谈、医生报告和尿液毒理学结果进行自我报告的措施。根据以前在其他领域的研究，假设可定制的基于计算机的版本的SOAPP-R将表现出更大的测量效率比短的形式和全长仪器。如果这一假设在数据中得到证实，那么拟议的研究将在帮助临床医生决定是否处方阿片类药物方面取得重要进展。

DESCRIPTION (provided by applicant): The Screener and Opioid Assessment for Patients with Pain - Revised (SOAPP-R) is a 24-item questionnaire that has been validated as a measure of risk of opioid abuse. While previous studies have compared the SOAPP-R favorably to other assessments in terms of sensitivity and specificity, the screener is currently only available in paper-and-pencil format. Moreover, it may be too long for certain respondents, particularly compromised individuals such as people in poor health and people who have difficulty with reading comprehension. Shorter versions of the SOAPP-R that maintain adequate sensitivity and specificity are therefore needed. The proposed research represents a fundamental first step toward filling this gap by providing a "proof of principle" for shorter computer-based versions of the instrument. These computer-based versions utilize interim analyses (calculations that are performed while assessment is in progress) to customize the questionnaire at the level of the individual respondent. The customizable procedures to be studied include curtailment, stochastic curtailment, and decision trees, all of which have been successfully applied to assessments in other domains. Additionally, static (non-customizable) short forms of the SOAPP-R will be developed that can be used by practitioners who do not have the capability to implement computer-based questionnaires. The first goal of the proposed research is to develop a computer program that performs and evaluates all procedures (curtailment, stochastic curtailment, decision trees, short forms, and the full-length SOAPP-R) on a given dataset. Evaluation of procedures will include statistics related to classification accuracy (e.g., sensitivity and specificity) as well as statistics related to respondent burden (e.., mean and standard deviation of the number of items administered). The second goal of the proposed research is to compare the aforementioned procedures using a dataset of 428 individuals who took the full-length SOAPP-R and were followed up to determine whether they had engaged in aberrant medication-related behavior. The follow-up determination was made via the Aberrant Drug Behavior Index (ADBI), a measure that incorporates self-report via structured interview, physician report, and urine toxicology results. Based on previous research in other domains, it is hypothesized that the customizable computer-based versions of the SOAPP-R will exhibit greater measurement efficiency than both the short forms and the full-length instrument. If this hypothesis is borne out in the data, the proposed research will constitute an important advance in helping clinicians make a decision to prescribe or not prescribe opioids.