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

描述（由申请人提供）：疼痛患者的筛选和阿片类药物评估-修订（soap - 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。虽然以前的研究在敏感性和特异性方面比较了soap - r优于其他评估，但筛选器目前仅以纸笔格式提供。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和阅读理解有困难的人。因此，需要保持足够灵敏度和特异性的soap - r的较短版本。拟议的研究代表了填补这一空白的根本性的第一步，为更短的基于计算机的仪器版本提供了“原理证明”。这些基于计算机的版本利用中期分析（在评估进行过程中进行的计算）在个别应答者的水平上定制问卷。研究的可定制过程包括裁剪、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，soap - r的静态（不可定制的）简短形式将被开发出来，供没有能力实现基于计算机的问卷调查的从业者使用。该研究的第一个目标是开发一个计算机程序，该程序可以在给定的数据集上执行和评估所有程序（缩减、随机缩减、决策树、简短形式和全长soap - r）。对程序的评估将包括与分类准确性（例如，敏感性和特异性）以及与应答者负担（例如，评估结果）相关的统计数据。，所给项目数的平均值和标准差)。该研究的第二个目标是使用428个使用完整soap -r的个体的数据集来比较上述程序，并随访以确定他们是否从事异常的药物相关行为。通过异常药物行为指数（ADBI）进行随访，这是一种结合结构化访谈自我报告、医生报告和尿液毒理学结果的测量方法。根据先前在其他领域的研究，假设基于计算机的可定制soap - r版本将比短形式和全长仪器表现出更高的测量效率。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开或不开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.