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

描述(由申请人提供)：疼痛患者筛查和阿片类药物评估修订(SOAPP-R)是一份24个项目的问卷，已被确认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在灵敏度和特异度方面与其他评估进行了有利的比较，但该筛查器目前仅以纸和笔的形式提供。此外，对于某些受访者来说，这可能太长了，特别是健康状况不佳的人和阅读理解有困难的人。因此，需要SOAPP-R的较短版本，以保持足够的敏感性和特异性。这项拟议的研究代表了填补这一空白的基本第一步，它为该仪器的较短计算机版本提供了“原则证明”。这些基于计算机的版本利用中期分析(在评估进行期间进行的计算)在单个受访者一级定制调查问卷。要研究的可定制程序包括裁剪、随机裁剪和决策树，所有这些都已成功地应用于其他领域的评估。此外，将开发SOAPP-R的静态(不可定制)缩写形式，供没有能力执行基于计算机的调查问卷的从业人员使用。拟议研究的第一个目标是开发一个计算机程序，该程序执行和评估给定数据集上的所有程序(裁剪、随机裁剪、决策树、简表和全长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)以及与答复者负担有关的统计数据(例如，管理的项目数量的平均和标准差)。这项拟议研究的第二个目标是使用428名服用全长SOAPP-R的人的数据集来比较上述程序，并对他们进行跟踪，以确定他们是否参与了与药物有关的异常行为。通过异常药物行为指数(ADBI)进行随访，ADBI是一种结合了结构化访谈的自我报告、医生报告和尿毒学结果的衡量标准。基于以前在其他领域的研究，假设SOAPP-R的可定制计算机版本将显示出比短形式和全长工具都更高的测量效率。如果这一假设在数据中得到证实，拟议的研究将在帮助临床医生决定是否开出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.