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Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report

BACKGROUND: The relationship between drug use and traumatic injury is well documented, yet only a small proportion of patients are biochemically tested for cannabis and other substances. The study objective was to determine whether patient self-report can be used as a proxy for biochemical drug test...

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Autores principales: Salottolo, Kristin, McGuire, Emmett, Madayag, Robert, Tanner, Allen H., Carrick, Matthew M., Bar-Or, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178863/
https://www.ncbi.nlm.nih.gov/pubmed/35676744
http://dx.doi.org/10.1186/s42238-022-00139-8
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author Salottolo, Kristin
McGuire, Emmett
Madayag, Robert
Tanner, Allen H.
Carrick, Matthew M.
Bar-Or, David
author_facet Salottolo, Kristin
McGuire, Emmett
Madayag, Robert
Tanner, Allen H.
Carrick, Matthew M.
Bar-Or, David
author_sort Salottolo, Kristin
collection PubMed
description BACKGROUND: The relationship between drug use and traumatic injury is well documented, yet only a small proportion of patients are biochemically tested for cannabis and other substances. The study objective was to determine whether patient self-report can be used as a proxy for biochemical drug testing following traumatic injury. METHODS: This study was a secondary analysis that included 320 patients admitted to four level I trauma centers in Colorado and Texas, primarily involved in motor vehicle crash (89%). If performed, biochemical testing was collected via urine toxicology screen (“tox screen”) for cannabis, amphetamines, barbiturates, cocaine, opiates, PCP, and benzodiazepines. All patients were screened for self-reported current drug use, which was evaluated for any drug and specifically for cannabis use. Analyses used to compare results of self-reported drug use and tox screen included sensitivity, specificity, positive, and negative predictive values, and percent agreement. RESULTS: Among 320 patients, 23% (n = 75) self-reported drug use; cannabis was the most frequently reported drug (n = 63). A tox screen was performed in 59% of patients (n = 190); the proportion of patients who had a tox screen was similar for those self-reporting drug use (60.0%) to those who denied using drugs (59.2%), p = 0.90. Among patients who had a tox screen performed, 18% (n = 35) tested positive for any drug, 12% (n = 22) tested positive for THC, and 7% (n = 13) tested positive for opiates. The percent agreement was 80% for any drug and 81% for cannabis. The specificity was 84–85%, indicating a high likelihood that a patient will not have a positive tox screen if they do not report using drugs. Negative predictive values were 90–95%, indicating a negative self-report correctly identified nearly all patients testing negative on tox screen. Sensitivity was only 60% and positive predictive values were 30–47% for cannabis and drugs, respectively. CONCLUSION: These findings may negate the need for biochemical drug testing in this population, particularly as a “rule out” based on self-reporting. Future studies are needed to confirm these findings and should address risk of selection bias.
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spelling pubmed-91788632022-06-10 Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report Salottolo, Kristin McGuire, Emmett Madayag, Robert Tanner, Allen H. Carrick, Matthew M. Bar-Or, David J Cannabis Res Brief Research Report BACKGROUND: The relationship between drug use and traumatic injury is well documented, yet only a small proportion of patients are biochemically tested for cannabis and other substances. The study objective was to determine whether patient self-report can be used as a proxy for biochemical drug testing following traumatic injury. METHODS: This study was a secondary analysis that included 320 patients admitted to four level I trauma centers in Colorado and Texas, primarily involved in motor vehicle crash (89%). If performed, biochemical testing was collected via urine toxicology screen (“tox screen”) for cannabis, amphetamines, barbiturates, cocaine, opiates, PCP, and benzodiazepines. All patients were screened for self-reported current drug use, which was evaluated for any drug and specifically for cannabis use. Analyses used to compare results of self-reported drug use and tox screen included sensitivity, specificity, positive, and negative predictive values, and percent agreement. RESULTS: Among 320 patients, 23% (n = 75) self-reported drug use; cannabis was the most frequently reported drug (n = 63). A tox screen was performed in 59% of patients (n = 190); the proportion of patients who had a tox screen was similar for those self-reporting drug use (60.0%) to those who denied using drugs (59.2%), p = 0.90. Among patients who had a tox screen performed, 18% (n = 35) tested positive for any drug, 12% (n = 22) tested positive for THC, and 7% (n = 13) tested positive for opiates. The percent agreement was 80% for any drug and 81% for cannabis. The specificity was 84–85%, indicating a high likelihood that a patient will not have a positive tox screen if they do not report using drugs. Negative predictive values were 90–95%, indicating a negative self-report correctly identified nearly all patients testing negative on tox screen. Sensitivity was only 60% and positive predictive values were 30–47% for cannabis and drugs, respectively. CONCLUSION: These findings may negate the need for biochemical drug testing in this population, particularly as a “rule out” based on self-reporting. Future studies are needed to confirm these findings and should address risk of selection bias. BioMed Central 2022-06-08 /pmc/articles/PMC9178863/ /pubmed/35676744 http://dx.doi.org/10.1186/s42238-022-00139-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Brief Research Report
Salottolo, Kristin
McGuire, Emmett
Madayag, Robert
Tanner, Allen H.
Carrick, Matthew M.
Bar-Or, David
Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report
title Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report
title_full Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report
title_fullStr Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report
title_full_unstemmed Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report
title_short Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report
title_sort validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report
topic Brief Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178863/
https://www.ncbi.nlm.nih.gov/pubmed/35676744
http://dx.doi.org/10.1186/s42238-022-00139-8
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