Classification of Substance Use Severity and Treatment Outcomes: NIDA CTN Studies

物质使用严重程度和治疗结果的分类：NIDA CTN 研究

• 批准号: 8133990
• 负责人: Li-Tzy Wu
• 金额: $ 36.56万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8133990
• 关键词: Address; Alcohol or Other Drugs use; Algorithms; Area; Beck depression inventory; Biological; Classification; Clinical; Clinical Trials Network; Data; Data Analyses; Data Files; Data Set; Diagnosis; Diagnostic; Diagnostic and Statistical Manual; Drug Addiction; Drug usage; Equipment and supply inventories; Ethnic Origin; Ethnic group; Foundations; Frequencies; Future; Gender; HIV; Health; Hybrids; Individual; Measurement; Measures; Mediator of activation protein; Mental Depression; Mental Health; Methods; Modeling; National Institute of Drug Abuse; Outcome; Participant; Patient Self-Report; Pattern; Phase; Probability; Quality of life; Race; Randomized; Randomized Clinical Trials; Research; Risk; Risk Behaviors; SF-36; Severities; Sex Characteristics; Solid; Symptoms; Treatment outcome; Work; addiction; data modeling; demographics; design; diagnosis quality; follow-up; health related quality of life; improved; indexing; insight; instrument; meetings; programs; psychological distress; racial and ethnic; racial and ethnic disparities; racial/ethnic difference; response; sex; statistics; theories; treatment trial

DESCRIPTION (provided by applicant): This R21/R33 application is in response to RFA-DA-09-020. It seeks support to address one research area recommended by this RFA "Secondary data analyses of multiple trials in the NIDA Clinical Trials Network (CTN)." By capitalizing on the CTN's wealth of multisite treatment data from multiple trials, we seek to, in the R21 phase (Year 1), 1) identify and create analyzable flat data files from the raw trial data (stacked format), 2) generate study variables and codebooks by programming scoring algorithms for multiple standardized clinical instruments, 3) evaluate the extent of missing data, and 4) examine baseline clinical profiles (substance use and diagnoses, mental health, and quality of life) of trial participants by gender and race/ethnicity in order to guide the R33 phase of work. In the R33 phase (Years 2-4), we plan to evaluate the construct, concurrent, and predictive validity of categorical and dimensional models of substance use diagnoses. The multisite CTN trials present an unparalleled, excellent opportunity to explore and evaluate these clinically and scientifically important issues directly related to treatment outcomes and to the emerging Diagnostic and Statistical Manual Version-IV (DSM-V). Study Aims for R33 are to 1) investigate measurement equivalence of DSM-IV diagnostic questions by gender and race/ethnicity, 2) evaluate the construct and concurrent validity of DSM-IV substance use diagnoses using categorical, dimensional, and integrated hybrid models of diagnostic classification, 3) determine empirically defined drug dependence subtypes (an integrated hybrid model) in predicting subsequent outcomes and to explore the mediator and moderators of the associations, and 4) evaluate empirically-defined comorbid drug dependence subtypes in predicting subsequent outcomes and to explore the mediator and moderators of the associations. Gender/sex differences will be examined in all analyses either through stratified analyses or the inclusions of interaction terms as appropriate. PUBLIC HEALTH RELEVANCE: Randomized clinical trials dominate treatment research today. Findings from the proposed study will make unique contributions to randomized addiction treatment research. They will help inform gender and racial/ethnic differences in the clinical profiles of substance use diagnoses, the quality and clinical utility of self-report diagnostic measures, interpretations of study results within the CTN, and future designs and analyses of addiction treatment trials.

描述（由申请人提供）：此 R21/R33 申请是对 RFA-DA-09-020 的回应。它寻求支持来解决本 RFA 推荐的一个研究领域“NIDA 临床试验网络 (CTN) 中多项试验的二次数据分析”。通过利用 CTN 来自多个试验的丰富的多站点治疗数据，我们寻求在 R21 阶段（第 1 年），1) 从原始试验数据（堆叠格式）中识别并创建可分析的平面数据文件，2) 生成研究通过为多个标准化临床仪器编程评分算法来获取变量和密码本，3) 评估缺失数据的程度，4) 检查基线临床概况（物质使用和诊断、心理健康和生活质量）按性别和种族/民族划分试验参与者，以指导 R33 阶段的工作。在 R33 阶段（第 2-4 年），我们计划评估物质使用诊断的分类和维度模型的构建、并发和预测有效性。多中心 CTN 试验提供了一个无与伦比的绝佳机会来探索和评估这些与治疗结果和新兴的诊断和统计手册第四版 (DSM-V) 直接相关的临床和科学重要问题。 R33 的研究目标是 1) 按性别和种族/族裔调查 DSM-IV 诊断问题的测量等效性，2) 使用诊断的分类、维度和集成混合模型评估 DSM-IV 物质使用诊断的构建和并发有效性分类，3) 确定经验定义的药物依赖亚型（综合混合模型）来预测后续结果，并探索关联的中介因素和调节因素，4) 评估经验定义的药物依赖性亚型（综合混合模型）共病药物依赖亚型在预测后续结果中的作用，并探索关联的中介和调节因素。所有分析中都将通过分层分析或酌情纳入交互项来检查性别差异。 公共卫生相关性：随机临床试验主导着当今的治疗研究。拟议研究的结果将为随机成瘾治疗研究做出独特的贡献。它们将有助于了解物质使用诊断临床概况中的性别和种族/民族差异、自我报告诊断措施的质量和临床效用、CTN 内研究结果的解释以及成瘾治疗试验的未来设计和分析。