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PubMedDate not supplied

A comparison of three rating scales for measuring subjective phenomena in clinical research. II. Use of experimentally controlled visual stimuli.

BACKGROUND: In a previous study of three types of global scales we found that verbal rating scales were particularly reliable for rating auditory stimuli. We now wanted to check the performance of the scales for rating experimentally controlled visual stimuli. METHODS: We used a prospective, experimentally controlled, clinimetric study, which was conducted at the Department of Psychiatry of the Autonomous University of Puebla Medical School in the state capital city of Puebla, Mexico. A total of 20 fifth-year medical students participated in the study. Visual stimuli consisted of 15 cards with five different intensities on the gray-to-black scale, administered randomly in three sessions to each subject. With regard to main outcome measurement, validity and consistency indices were determined for visual analog scale (VAS), numerical rating score (NRS), and verbal rating scale (VRS) to rate visual stimuli. RESULTS: For validity, correlation coefficients between scales and reference standard were high, especially in VRS (r=0.902). For consistency, VRS had highest kappa value (k(w)=0.71) for interobserver variability. CONCLUSIONS: Three instruments could be hierarchically ranked for their indices of validity and consistency. Being more consistent than VAS and NRS, VRS merits more frequent usage in clinical research.

Biomedical Research↗
PubMed2005

Revising the Belgian Nursing Minimum Dataset: from concept to implementation.

The process of revising the Belgian Nursing Minimum Dataset (B-NMDS) started in 2000 and entailed four major phases. The first phase (June-October 2002) involved the development of a conceptual framework based on a literature review and secondary data analysis. The Nursing Interventions Classification (NIC) was selected as a framework for the revision of the original B-NMDS. The second phase (November 2002-September 2003) focused on language development for six care programs evaluated by panels of clinical experts (N=75). These panels identified the following items as priorities for the revised B-NMDS: hospital financing, nurse staffing allocation, assessment of the appropriateness of hospitalisation, and quality management. During this period, we developed a draft instrument with 92 variables using the NIC. This led to an alpha version of a revised B-NMDS. The third phase (October 2003-December 2004) focused on data collection and validation of the new tool. The revised B-NMDS (alpha version) was tested in 158 nursing wards in 66 Belgian hospitals from December 2003 until March 2004. This test generated data for some 95,000 in-patient days. The interrater reliability of the revised B-NMDS was assessed. The criterion-related validity of the revised B-NMDS was compared to that of the original B-NMDS. The discriminative power of the revised B-NMDS was also assessed to select the most relevant variables for data collection. This resulted in a beta version of the revised B-NMDS in December 2004. The records of the revised B-NMDS were linked to the Hospital Discharge Dataset and other mandatory datasets to integrate the revised B-NMDS into the overall healthcare management system. The fourth phase (January 2005-December 2005) is presently focusing on information management. Nationwide implementation is foreseen by January 2007.

Belgium↗
PubMed2006

Investigation to find a suitable reference material for use as an inverse gas chromatography system suitability test.

The purpose of this study was to find a suitable material for use as a system suitability test material for inverse gas chromatography (IGC). The purpose of a system check is to measure the variability of the instrument being used rather than the material being analysed. Having such a system check for IGC enables a basic GMP requirement to be met. IGC results can then be used in regulatory submissions to support other already established techniques for characterising pharmaceutical materials. Alpha-alumina was chosen because it is inorganic, stable at high temperatures, resistant to hydration and is already established as a system check material for surface area determination by nitrogen adsorption. Two columns (1 and 2) packed from the same reference sample jar of alpha-alumina and analysed under the same conditions yielded dispersive surface energies of 34.8+/-0.8 and 35.3+/-0.8 mJ/m(2), respectively, at 15% RH. Column 1 was analysed on a second IGC system, and gave a dispersive surface energy of 34.7+/-0.2 mJ/m(2). No significant change was evident after 7 months storage under laboratory ambient conditions. Analysis of material from a second reference sample jar of alpha-alumina produced results not noticeably different to those of the first, yielding a dispersive surface energy of 35.3+/-0.1 mJ/m(2). A change was seen to occur in the surface properties alpha-alumina when the humidity was varied, but the change appeared to be consistent across the two columns reported. Based upon the data in this experimental, alpha-alumina appears to be a suitable material for use as a system suitability test material for IGC.

Aluminum Oxide↗
PubMed2006

Monoaminergic system lesions increase post-sigh respiratory pattern disturbance during sleep in rats.

Monoamines are important regulators of behavioral state and respiratory pattern, and the impact of monoaminergic control during sleep is of particular interest for the stability of breathing regulation. The aim of this study was to test the effects of systemically induced chemical lesions to noradrenergic and serotonergic efferent systems, on the expression of sleep-wake states, pontine wave activity, and sleep-related respiratory pattern and its variability. In chronically instrumented male adult Sprague-Dawley rats we lesioned noradrenergic terminal axonal branches by a single intraperitoneal dose of DSP-4 (N-(2-chloroethyl)-N-ethyl-2-brombenzilamine; 50 mg/kg, i.p.), and serotonergic axonal terminals by two intraperitoneal doses, 24 h apart, of PCA (p-chloroamphetamine; 6 mg/kg, i.p.). In each animal, we recorded sleep, pontine waves (P-waves) and breathing at baseline, following sham injection, and every week for 5 weeks following injection of either systemic neurotoxin. Distinct responses were observed to the two lesions. DSP-4 lesions were associated with a trend toward increased NREM sleep (p < 0.06), decreased wakefulness (p < 0.05) and increased respiratory tidal volume during NREM (p = 0.0002) and REM (p = 0.0001) sleep with respect to baseline. None of these effects, however, were observed during the first 14 days after injection. No significant changes were observed in the frequency of apneas or sighs, nor in the coupling between these two, at any time after DSP-4 injection. Conversely, selective serotonergic lesion by PCA produced no change in the baseline respiratory frequency or tidal volume during sleep or wakefulness, nor was the expression of Wake, NREM or REM sleep affected. Instead, PCA injection resulted in a sustained increase in the frequency and duration of post-sigh apneas (PS) during NREM sleep (p = 0.002). This reflected increased coupling between sighs and apneas, because neither the frequency nor the amplitude of spontaneous sighs was altered by PCA.

Adrenergic Fibers↗
PubMedDate not supplied

Tower of Hanoi and WCST performance in schizophrenia: problem-solving capacity and clinical correlates.

We administered a computerized version of WCST, a well established test, sensitive to executive function deficits in schizophrenia that involves many features of cognitive processing, and of Tower of Hanoi, a test that may offer cognitive challenges more specifically related to planning and sequencing, to 28 schizophrenic patients and 28 matched controls to examine a worthwhile question regarding the relative ability of these two tasks to differentiate schizophrenia and normal groups as well as exploring the relationship of these two instruments to clinical variables. The schizophrenic patients performed significantly worse than normal subjects both on Tower of Hanoi test and on WCST. The discriminant analysis identified in a multivariate way a pattern of indexes that differentiate the two groups. This pattern, characterized by specific indexes of WCST and TOH, could suggest the existence of a common underlying factor that determines the cognitive impairment in problem-solving of schizophrenics. These findings and the relationship with positive and negative symptoms have been discussed in the light of the model of the impairment in the internal representation of context information.

Adult↗
PubMed2000

Parental representation in eating disorder patients with suicide.

OBJECTIVE: We examined parental, personality, and symptomatological characteristics in relation to suicide attempts among eating disorder patients. METHODS: Fifty-one eating disorder inpatients, divided into two groups according to lifetime suicide attempts, and 107 non-psychiatric subjects were compared on the following variables: Parental Bonding Instrument (PBI), Global Clinical Score (GCS), Eating Disorder Inventory-91 (EDI-91), Eating Attitudes Test-26 (EAT), clinical and personality characteristics, and family backgrounds. RESULTS: Suicidal patients reported significantly higher overprotection by both parents than non-suicidal patients and non-psychiatric subjects. Suicidal patients had a more prevalent history of child abuse, affective instability, unstable self-image, avoidance of abandonment, maladaptive perfectionism, personality disorder, and mood disorder. There were no differences in symptomatological factors or the severity of the eating disorders. CONCLUSION: The results suggest that high overprotection is associated with suicidal behaviour in eating disorder patients. The association between overprotective parenting and personality characteristics, and methods of suicide prevention are discussed briefly.

Adolescent↗
PubMed2000

Routine determination of sulfonylurea, imidazolinone, and sulfonamide herbicides at nanogram-per-liter concentrations by solid-phase extraction and liquid chromatography/mass spectrometry.

Sulfonylurea (SU), imidazolinone (IMI), and sulfonamide (SA) herbicides are new classes of low-application-rate herbicides increasingly used by farmers. Some of these herbicides affect both weed and crop species at low dosages and must be carefully used. Less is known about the effect of these compounds on non-crop plant species, but a concentration of 100 ng/l in water has been proposed as the threshold for possible plant toxicity for most of these herbicides. Hence, analytical methods must be capable of detecting SUs, IMIs, and SAs at concentrations less than 100 ng/l in ambient water samples. The authors developed a two-cartridge, solid-phase extraction method for isolating 12 SU, 3 IMI, and 1 SA herbicides by using high-performance liquid chromatography/electrospray ionization-mass spectrometry (HPLC/ESI-MS) to identify and quantify these herbicides to 10 ng/l. This method was used to analyze 196 surface- and ground-water samples collected from May to August 1998 throughout the Midwestern United States, and more than 100 quality-assurance and quality-control samples. During the 16 weeks of the study, the HPLC/ESI-MS maintained excellent calibration linearity across the calibration range from 5 to 500 ng/l, with correlation coefficients of 0.9975 or greater. Continuing calibration verification standards at 100-ng/l concentration were analyzed throughout the study, and the average measured concentrations for individual herbicides ranged from 93 to 100 ng/l. Recovery of herbicides from 27 reagent-water samples spiked at 50 and 100 ng/l ranged from 39 to 92%, and averaged 73%. The standard deviation of recoveries ranged from 14 to 26%, and averaged 20%. This variability reflects multiple instruments, operators, and the use of automated and manual sample preparation. Spiked environmental water samples had similar recoveries, although for some herbicides, the sample matrix enhanced recoveries by as much as 200% greater than the spiked concentration. This matrix enhancement was sample- and compound-dependent. Concentrations of herbicides in unspiked duplicate environmental samples were typically within 25% of each other. The results demonstrate the usefulness of HPLC/ESI-MS for determining low-application-rate herbicides at ambient concentrations.

Chromatography, High Pressure Liquid↗
PubMed1998

The so-called "placebo effect" in benign prostatic hyperplasia treatment trials represents partially a conditional regression to the mean induced by censoring.

OBJECTIVES: To study the variability of assessment instruments (symptom questionnaires and flow rate recordings) in healthy volunteers during repeat administration in short intervals. To study the effect of inclusion criteria-based censoring of patients during screening for benign prostatic hyperplasia (BPH) treatment trials on the outcome of subsequent tests. METHODS: One hundred forty-five male volunteers without known prostatic diseases with a mean age of 52 years (range 23 to 83) were given the American Urological Association (AUA) Symptom Index (SI), BPH Impact Index (II). Quality of Life (QOL) score, and a flow rate recording twice 10 to 20 days apart without any healthcare intervention. Data were collected and analyzed after typical BPH trial criteria were applied to the first test, and patients who did not "qualify" were censored. RESULTS: Good correlation exists between two closely spaced administrations of the AUA SI, BPH II, QOL score, and flow rate recordings in healthy male volunteers with correlation coefficients between 0.73 and 0.89. Censoring patients and excluding them from the analysis of the second test based on typical BPH trial criteria induces a regression to the mean phenomenon, which results in an artificial improvement in these outcome parameters. The magnitude of the improvement increases as the selection and censoring criteria tighten. The mean differences between the first and second test range from 1.4 to 1.7 mL/s for the peak flow rate, from -1.0 to -1.4 for the AUA SI, and from -0.4 to -0.8 for the BPH II. All these differences induced solely by censoring with resulting regression to the mean are statistically significant. CONCLUSIONS: Censoring of patients based on inclusion and exclusion criteria is typical for BPH treatment trials. One of the under-recognized effects of censoring is a regression to the mean, which leads to an apparent improvement in the outcome parameters assessed. In both placebo or sham-controlled trials, as well as in clinical series without controls, one must keep this effect and its relative magnitude in mind, and interpret the data from such trials with appropriate caution.

Adult↗
PubMed2003

Illicit drug use, cigarette smoking and alcohol drinking behaviour among a sample of high school adolescents in the Pietersburg area of the Northern Province, South Africa.

AIM: The aim of this study was to investigate the prevalence of illicit drug use, cigarette smoking and alcohol drinking behaviour among a sample of high-school adolescents in the Pietersburg area (Central Region) of the Northern Province, South Africa. PARTICIPANTS: Participants in this study were 435 secondary-school adolescent students around the Pietersburg area (Central Region), in the Northern Province. Two hundred and forty-three (56%) participants were female and 192 (44%) were male. They were aged between 15 and 19 years, with the mean age of 17.25 years (S.D.=1.34). Their educational level ranged between standards 7 and 10 (Grades 9-12). INSTRUMENTS: Participants' demographic variables were determined by use of a questionnaire which covered participants personal characteristics such as age and gender, as well as educational level. Illicit drug use, cigarette smoking, and alcohol drinking behaviour were also measured using the questionnaire. RESULTS: Findings of this study indicate the prevalence rate of 19.8% for illicit drug use, 10.6% for cigarette smoking and 39.1% for alcohol consumption among the participants. Both drug use, cigarette smoking and alcohol consumption are associated more with males than with females. The majority of the drug users and cigarette smokers indicated that they do so when they are bored, tired or stressed up, or at parties; and most of those who drink alcohol indicated that they do so at parties, weekends, or any other time. The mean age for first drug use is 14.9 years (S.D.=1.77); 14.54 years (S.D.=1.80) for first cigarette smoking and 15.33 years (S.D.=1.91) for first alcohol consumption. Among those who drink alcohol, 24.1% and 14.1% experience unplanned drunkenness and irritability, respectively. Unplanned drunkenness is associated with males, while unplanned irritability (after drinking alcohol) is not associated with any gender. CONCLUSION: Mental health workers and the law-enforcement agencies should take note of the above findings while planning preventive and therapeutic strategies for the reduction of drug use, cigarette smoking and alcohol use and abuse among adolescents in the area.

Adolescent↗
PubMed2002

Precision and sensitivity of aminobiphenyl hemoglobin adduct assays in a long-term population study.

Exploratory statistical analysis of aminobiphenyl hemoglobin adduct data obtained in a large-scale population study was performed to assess precision and sensitivity over the 7 years required to conduct the analyses. A time-dependent trend toward higher values was observed that may be attributable to aging of the internal standard used throughout the study. A several-fold improvement in sensitivity from the beginning to end of the study was also noted. Repeated analysis of duplicate blood specimens provided a worst-case estimate of the coefficient of variation to be 0.31, attributable almost entirely to sample preparation rather than instrumental analysis. Substantial variability in calibration curves for the deuterated internal standard (standard deviation was +/-15% of the mean) was observed. The results obtained here will be used in support of further analyses of the data with respect to factors of epidemiological interest.

Aminobiphenyl Compounds↗
PubMed1999

Voltammetric and spectrophotometric techniques for the determination of the antihypertensive drug Prazosin in urine and formulations.

A sensitive method was developed to determine Prazosin using a nafion modified carbon paste electrode (NMCPE). Prazosin was accumulated at a potential of 750 mV in Britton-Robinson buffer (pH 6.0) and then a negative sweep was made obtaining a cathodic peak close to 0 V. Cyclic voltammetric studies indicated that the process was quasi-reversible, and fundamentally controlled by adsorption. To obtain a good sensitivity, the instrumental and accumulation variables were studied using differential pulse voltammetry (DPV). Adsorptive voltammetric peak currents showed a linear response for Prazosin concentrations in the range between 4.0 x 10(-11) and 4.0 x 10(-8) M with two different slopes, and a detection limit (LOD) of 3.1 x 10(-11)M was obtained. The variation coefficient (CV) for a 8.0 x 10(-10) M solution (n = 10) was 4.08%. A spectrophotometric study of Prazosin was also carried out and two absorption bands were obtained at 246 and 329 nm (pH 1.8). The band at 329 nm was pH-dependent and its height and position changed with the pH values, so this allowed the pK'a determination (7.14 +/- 0.20) using different methods. The detection limit reached by means of UV-spectrophotometry was 0.9 x 10(-7) M, and the variation coefficient for 1.5 x 10(-5) M Prazosin solutions was 1.14% (n = 10). Although the sensitivity of the UV-spectrophotometric method was lower than that obtained using adsorptive stripping-differential pulse voltammetry (AdS-DPV), it could be applied to the determination of Prazosin in Minipres tablets. The voltammetric method was used for the determination of the drug in human urine samples at trace levels with good recoveries.

Antihypertensive Agents↗
PubMed1999

Sonoclot coagulation analysis: a study of test variability.

OBJECTIVE: To test the reproducibility of Sonoclot coagulation analysis (SCA; Sienco Inc, Morrison, CO). The authors wished to determine if the mix/release of the preloaded celite activator in standard Sono-cuvettes could be responsible for the high variation coefficients for SCA parameters with citrated whole blood and if citrated whole blood is optimal for SCA. DESIGN: A prospective trial. SETTING: A large academic teaching medical center. PARTICIPANTS: Eight healthy volunteers. INTERVENTIONS: Repeated blood sampling was performed through indwelling radial artery catheters. Seven different Sonoclot analyzers were used to test seven different types of analysis procedures in the volunteers, involving activators of different types and amounts and in different forms, and the use of citrated or native whole blood. MEASUREMENTS AND MAIN RESULTS: Two-way and one-way ANOVA, variance, variance analysis, and Tukey's test were used to evaluate differences in SCA methods and volunteer influence. A high variance, with SDs up to 200% of the median values of the SCA parameters with recalcified citrated blood and the standard Sono-cuvette, was confirmed. SCA with native blood and/or the use of other types of preloaded activators, ie, kaolin, significantly (p < 0.05) reduced this variance. Repeated SCAs further reduced the variance to 10% to 35% of the variance for a single analysis (standard cuvette and native blood). CONCLUSION: Improvement of the activator in the Sonocuvette, use of native whole blood, and repeated Sonoclot analyses reduced the previously reported high variability of this instrument.

Adult↗
PubMed2006

Extracting chemical information from spectral data with multiplicative light scattering effects by optical path-length estimation and correction.

When analyzing complex mixtures that exhibit sample-to-sample variability using spectroscopic instrumentation, the variation in the optical path length, resulting from the physical variations inherent within the individual samples, will result in significant multiplicative light scattering perturbations. Although a number of algorithms have been proposed to address the effect of multiplicative light scattering, each has associated with it a number of underlying assumptions, which necessitates additional information relating to the spectra being attained. This information is difficult to obtain in practice and frequently is not available. Thus, with a view to removing the need for the attainment of additional information, a new algorithm, optical path-length estimation and correction (OPLEC), is proposed. The methodology is applied to two near-infrared transmittance spectral data sets (powder mixture data and wheat kernel data), and the results are compared with the extended multiplicative signal correction (EMSC) and extended inverted signal correction (EISC) algorithms. Within the study, it is concluded that the EMSC algorithm cannot be applied to the wheat kernel data set due to core information for the implementation of the algorithm not being available, while the analysis of the powder mixture data using EISC resulted in incorrect conclusions being drawn and hence a calibration model whose performance was unacceptable. In contrast, OPLEC was observed to effectively mitigate the detrimental effects of physical light scattering and significantly improve the prediction accuracy of the calibration models for the two spectral data sets investigated without any additional information pertaining to the calibration samples being required.

Algorithms↗
PubMed1976

An experimental method correcting for absorption flattening and scattering in suspensions of absorbing particles: circular dichroism and absorption spectra of hemoglobin in situ in red blood cells.

An experimental approach to interpretation of the anomalous absorption and circular dichroism (CD) spectra of hemoglobin in situ in red blood cells is reported. Absorption flattening effects have been overcome by use of high cell concentratons in very short light path cuvettes. Differential scattering contributions to circular dichroism have been resolved using a CD instrument capable of variable detection geometry. Scattering effects have also been resolved using media of high refractive index to match that of the red blood cell. The results are in agreement with a parellel calculational analysis of red blood cell CD spectra, which predicted the relative magnitudes of the flattening and differential scattering CD contributions. An experimental absorption spectrum has been obtained for hemoglobin in the red blood cell with scattering and flattening eliminated. This quantitatively simulates the spectrum of a hemoglobin solution. The methods described should be widely applicable to conformational studies of macromolecules in their native environment.

Circular Dichroism↗
PubMed2003

Breast cancer teams: the impact of constitution, new cancer workload, and methods of operation on their effectiveness.

National guidance and clinical guidelines recommended multidisciplinary teams (MDTs) for cancer services in order to bring specialists in relevant disciplines together, ensure clinical decisions are fully informed, and to coordinate care effectively. However, the effectiveness of cancer teams was not previously evaluated systematically. A random sample of 72 breast cancer teams in England was studied (548 members in six core disciplines), stratified by region and caseload. Information about team constitution, processes, effectiveness, clinical performance, and members' mental well-being was gathered using appropriate instruments. Two input variables, team workload (P=0.009) and the proportion of breast care nurses (P=0.003), positively predicted overall clinical performance in multivariate analysis using a two-stage regression model. There were significant correlations between individual team inputs, team composition variables, and clinical performance. Some disciplines consistently perceived their team's effectiveness differently from the mean. Teams with shared leadership of their clinical decision-making were most effective. The mental well-being of team members appeared significantly better than in previous studies of cancer clinicians, the NHS, and the general population. This study established that team composition, working methods, and workloads are related to measures of effectiveness, including the quality of clinical care.

Adult↗
PubMed2002

Benign prostatic hyperplasia: the opposite effects of alcohol and coffee intake.

OBJECTIVE: To assess several lifestyle factors influencing benign prostatic enlargement and therefore the severity of benign prostatic hyperplasia (BPH). SUBJECTS AND METHODS: In age-stratified cohorts from population-based random samples of 882 men (aged 65, 70, 75 and 80 years) each participant completed a standardized questionnaire, including weight, height, socio-economic status, use of cigarettes, alcohol and coffee consumption. The questionnaire also elicited detailed information on the medical history of prostatic and (over the past month) lower urinary tract symptoms, applying all questions from the American Urology Association instrument. The lifestyle variables were evaluated for confounding by multiple logistic regression, controlling for age, relative weight and professional education, with those classified as having BPH analysed as the dependent variable. RESULTS: The prevalence of surgery for BPH increased with age from 15% at 65 years to 41% at 80 years. There was a strong inverse association between alcohol intake and men treated surgically for BPH or in 'watchful waiting' for surgical intervention, but a positive correlation with coffee consumption, and although not significantly, with the number of cigarettes smoked. Nevertheless, those who had never smoked have a slightly greater risk of BPH than current smokers. The body mass index and professional education were not associated with the risk of BPH. CONCLUSIONS: Given the opposite effects of coffee and moderate alcohol consumption, together with the increased risk for clinical BPH in men with coronary heart disease, coffee constituents, which increase the serum concentration of low-density lipoprotein cholesterol, may be involved in the pathophysiology of BPH. Further epidemiological studies are needed to evaluate whether avoiding coffee intake reduces the risk of BPH.

Aged↗
PubMedDate not supplied

In vitro biomechanical properties of 2 compression fixation methods for midbody proximal sesamoid bone fractures in horses.

OBJECTIVE: To evaluate 2 methods of midbody proximal sesamoid bone repair--fixation by a screw placed in lag fashion and circumferential wire fixation--by comparing yield load and the adjacent soft-tissue strain during monotonic loading. STUDY DESIGN: Experimental study. SAMPLE POPULATION: 10 paired equine cadaver forelimbs from race-trained horses. METHODS: A transverse midbody osteotomy of the medial proximal sesamoid bone (PSB) was created. The osteotomy was repaired with a 4.5-mm cortex bone screw placed in lag fashion or a 1.25-mm circumferential wire. The limbs were instrumented with differential variable reluctance transducers placed in the suspensory apparatus and distal sesamoidean ligaments. The limbs were tested in axial compression in a single cycle until failure. RESULTS: The cortex bone screw repairs had a mean yield load of 2,908.2 N; 1 limb did not fail when tested to 5,000 N. All circumferential wire repairs failed with a mean yield load of 3,406.3 N. There was no statistical difference in mean yield load between the 2 repair methods. The maximum strain generated in the soft tissues attached to the proximal sesamoid bones was not significantly different between repair groups. CONCLUSIONS: All repaired limbs were able to withstand loads equal to those reportedly applied to the suspensory apparatus in vivo during walking. CLINICAL RELEVANCE: Each repair technique should have adequate yield strength for repair of midbody fractures of the PSB immediately after surgery.

Animals↗
PubMed2004

Screening for substance abuse in individuals with traumatic brain injury.

PRIMARY OBJECTIVE: To determine the utility of the CAGE, the Brief Michigan Alcohol Screening Test (BMAST) and the Substance Abuse Subtle Screening Inventory (SASSI-3) with individuals with traumatic brain injury (TBI), two studies were conducted examining the accuracy, sensitivity and specificity of these instruments. RESEARCH DESIGN: Data from self-report instruments were compared to a clinical interview, Structured Clinical Interview for DSM-IV (SCID), to determine the accuracy, sensitivity and specificity. METHODS AND PROCEDURES: Two studies were conducted. In study I, 100 individuals with TBI were screened for alcohol abuse using the CAGE and the resulting classifications were compared with those derived from the SCID. In study II, 223 individuals were screened for alcohol abuse and drug abuse using the BMAST and SASSI-3 and the results of these screenings were compared with diagnoses obtained by the SCID. MAIN OUTCOMES AND RESULTS: The specificity of the self-report instruments was moderately high, ranging between 81-83%. The specificity of the CAGE for alcohol abuse both pre- and post-TBI was high, 96% and 86%, respectively. The sensitivity of the self-report instruments was most variable, ranging from 32-95%, with the SASSI face valid drug scale and the CAGE alcohol post-TBI indicating the most sensitivity, 95 and 91%, respectively. CONCLUSIONS: The findings suggest that the CAGE may be useful in screening for alcohol abuse and the face valid drug sub-scale of the SASSI-3 may be useful in screening for drug abuse in individuals with TBI.

Adolescent↗