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Validity of self-reported substance use: research setting versus primary health care setting

机译：自我报告的物质使用的有效性：研究环境与初级保健设置

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Self-reported substance use is more likely to be influenced by underreporting bias compared to the biological markers. Underreporting bias or validity of self-reported substance use depends on the study population and cannot be generalized to the entire population. This study aimed to compare the validity of self-reported substance use between research setting and primary health care setting from the same source population. The population in this study included from Rafsanjan Youth Cohort Study (RYCS) and from primary care health centers. The sample from RYCS is made up 607 participants, 113 (18.62%) women and 494 (81.38%) men and sample from PHC centers is made up 522 individuals including 252 (48.28%) women and 270 (51.72%) men. We compared two groups in respect of prevalence estimates based on self-reported substance use and urine test. Then for evaluating validity of self-reported substance use in both group, the results of reference standard, urine tests, were compared with the results of self-reported drug use using measures of concordance. The prevalence of substance use based on urine test was significantly higher in both settings compared to self-reported substance use over the past 72?h. The sensitivity of self-report substance use over the past 72?h in research setting was 39.4, 20, 10% and zero for opium, methadone, cannabis and amphetamine, respectively and in primary health care setting was 50, 20.7, 12.5% and zero for opium, methadone, cannabis and amphetamine, respectively. The level of agreement between self-reported substance use over the past 72?h and urine test indicated fair and moderate agreement for opium in both research and primary health care settings, respectively and also slight agreement for methadone and cannabis in both settings were reported. There was no significant difference between the two groups in terms of self-reported substance use. For all substances, the level of agreement increased with longer recall periods. The specificity of self-report for all substances in both groups was more than 99%. Individuals in primary health care setting were more likely to self-reported substance use than in research setting, but setting did not have a statistically significant effect in terms of self-reported substance use. Programs that rely on self-reported substance use may not estimate the exact prevalence of substance use in both research and primary health care settings, especially for substances that have a higher social stigma. Therefore, it is recommended that self-report and biological indicators be used for more accurate evaluation in substance use studies. It is also suggested that future epidemiological studies be performed to reduce bias of social desirability and find a method providing the highest level of privacy.
机译：与生物标志物相比，自我报告的物质使用更可能受到肿瘤偏差的影响。经报告物质使用的额外偏差或有效性取决于研究人群，不能推广到整个人口。本研究旨在比较自我报告的物质在同一源人口中的研究环境和初级医疗保健环境之间的有效性。本研究中的人口包括从Rafsanjan青年队列研究（RYC）和初级保健卫生中心。 RYCS的样品由607名参与者组成，113名（18.62％）妇女和494名（81.38％）男性和来自PHC中心的样品是522个个体，其中包括252名（48.28％）和270名（51.72％）男性。我们将两组与自我报告的物质使用和尿液试验相比，两组就患病率估计进行了比较。然后，为了评估自我报告的自我报告物质在两组中使用的有效性，将参考标准的结果与使用一致性措施的自我报告的药物使用的结果进行比较。与过去72的自我报告的物质使用相比，两种环境中，基于尿液试验的物质使用的患病率显着高。在研究环境中，自我报告物质使用的敏感性在研究环境中使用39.4,20,10％和零，分别为50,20.7，12.5％和零嘌呤，美沙酮，大麻和安非他明的零。自我报告的物质在过去72次使用之间的协议水平分别表明了研究和初级保健环境中的鸦片和中等协议的公平和中等协议，并且还报告了两种环境中的美沙酮和大麻的轻微一致性。两组在自我报告的物质使用方面没有显着差异。对于所有物质，协议水平随着召回期的更长而增加。两组所有物质的自我报告的特异性超过99％。初级医疗环境中的个人更有可能是自我报告的物质使用，而不是研究环境，但在自我报告的物质使用方面，环境没有统计学上显着的影响。依赖于自我报告的物质使用的程序可能无法估算研究和初级保健环境中的物质使用的确切普及，特别是对于具有更高社会耻辱的物质。因此，建议使用自我报告和生物指标用于物质使用研究的更准确评估。还建议进行未来的流行病学研究，以减少社会期望的偏见，并找到提供最高隐私水平的方法。

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