Refining the Diagnosis of Alcohol Use Disorder: A Comprehensive Approach

完善酒精使用障碍的诊断：综合方法

• 批准号: 9136037
• 负责人: KENNETH JAMES SHER
• 金额: $ 46.88万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-05 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9136037
• 关键词: Address; Alcohol consumption; Alcohol withdrawal syndrome; Alcoholism; Alcohols; Algorithms; Assessment tool; Behavior Therapy; Benchmarking; Classification; Clinical; Clinical Data; Cognitive; Communities; Comorbidity; Computational Science; Computer software; Consumption; Country; Data; Data Analyses; Data Set; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Diagnostic and Statistical Manual of Mental Disorders; Disease; Documentation; Drug usage; Epidemiology; Evaluation; Goals; Gold; Gross National Product; Health; Heavy Drinking; Income; Individual; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10); Lead; Measurement; Methodology; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Outcome; Outcome Study; Participant; Performance; Pharmaceutical Preparations; Prevalence; Property; Psychometrics; Public Health; Publications; Publishing; Research; Research Personnel; Sampling; Science; Site; Societies; Strategic Planning; Structure; Substance Use Disorder; Surveys; Symptoms; Techniques; Treatment outcome; Validation; Withdrawal; Work; alcohol related problem; alcohol use disorder; base; clinical practice; clinically relevant; cost; craving; data sharing; density; economic cost; genetics of alcoholism; high risk; improved; innovation; interest; joint function; mortality; novel strategies; population based; programs; response; statistics; theories; trait; user-friendly

 DESCRIPTION (provided by applicant): Excessive alcohol use has many negative health consequences, including higher risk of mortality. In addition, the estimated economic cost of excessive drinking is more than 1% of the gross national product in high- income and middle-income countries (Rehm et al., 2009). The over-arching goal of this application is to improve the definition and assessment of alcohol use disorder (AUD). Our proposal is consistent with the goals outlined in the most recent NIAAA Strategic Plan (2009-2014). Most broadly, our study will develop and validate optimal diagnostic criteria sets and algorithms (ODCSAs) for the diagnosis of AUD that we anticipate will perform substantially better than existing diagnostic criteria (i.e. DSM-5 and ICD-10). We will employ emerging methods and develop and apply new methods in statistics and classification science to existing large population-based epidemiological data sets (the National Epidemiological Survey of Alcoholism and Related Conditions, NESARC; the National Longitudinal Alcohol Epidemiologic Survey, NLAES; the National Survey on Drug Use and Health, NSDUH), a large multi-site sample enriched for high density of AUDs (the Collaborative Study on the Genetics of Alcoholism, COGA), a major, multi-site treatment outcome study (Combining Medications and Behavioral Interventions; COMBINE) and two smaller non-clinical and clinical data sets spanning a decade or more of participants lives in order to refine assessment methods, diagnostic criteria, and diagnostic algorithms for AUDs. Specifically, by employing state-of-the art techniques in data harmonization and computational statistics, we will identify those criteria sets and decision rules that will optimize the associaton with heaviness of alcohol consumption, both within and across data sets. These new ODCSAs will then be subjected to extensive evaluation of their structural validity and external validity. n addition, we will conduct extensive validation analyses of DSM-5, ICD-10, and draft ICD-11 criteria, because these are of interest in their own right, and because that will allow us to benchmark our new ODCSAs with the current standards. We believe the development of empirically-based diagnosis for AUD will improve research on the causes and correlates of AUD and should lead to improved diagnostic criteria for clinical practice. The methods developed for this application should have broad applicability for developing diagnostic criteria or assessment instruments for a range of clinically important constructs when there are no clear "gold standards." The proposed research exploits increased availability of data sharing, new developments in data harmonization, and advances in computational science.

 描述（由申请人提供）：过量饮酒会对健康产生许多负面影响，包括更高的死亡风险。此外，在高收入和中等收入国家，过度饮酒的估计经济成本占国民生产总值的 1% 以上（Rehm 等，2009）。该应用程序的首要目标是改进酒精使用障碍 (AUD) 的定义和评估。我们的建议与最新的 NIAAA 战略计划（2009-2014）中概述的目标一致。最广泛地说，我们的研究将开发和验证用于 AUD 诊断的最佳诊断标准集和算法 (ODCSA)，我们预计其性能将大大优于现有的诊断标准（即 DSM-5 和 ICD-10）。我们将采用新兴方法，并开发和应用统计和分类科学中的新方法到现有的基于人群的大型流行病学数据集（国家酒精中毒及相关疾病流行病学调查，NESARC；国家纵向酒精流行病学调查，NLAES；国家药物使用和健康调查，NSDUH），这是一个针对高密度 AUD 进行丰富的大型多站点样本（关于酒精中毒和相关疾病的合作研究） 酒精中毒遗传学 (COGA)、一项主要的多中心治疗结果研究（结合药物和行为干预；COMBINE）以及两个较小的非临床和临床数据集，涵盖参与者十年或更长时间的生活，以完善 AUD 的评估方法、诊断标准和诊断算法。具体来说，通过采用最先进的数据协调和计算统计技术，我们将确定那些标准集和决策规则，以优化数据集内和数据集之间与饮酒量的关联。然后，这些新的 ODCSA 将对其结构有效性和外部有效性进行广泛评估。此外，我们将对 DSM-5、ICD-10 和 ICD-11 标准草案进行广泛的验证分析，因为这些标准本身就很有意义，而且这将使我们能够根据现行标准对新的 ODCSA 进行基准测试。我们相信，基于经验的 AUD 诊断的发展将改善对 AUD 原因和相关性的研究，并应改进临床实践的诊断标准。当没有明确的“金标准”时，为此应用开发的方法应该具有广泛的适用性，可用于为一系列临床重要结构开发诊断标准或评估工具。拟议的研究利用了数据共享可用性的提高、数据协调的新发展以及计算科学的进步。