Refining the Diagnosis of Alcohol Use Disorder: A Comprehensive Approach

完善酒精使用障碍的诊断：综合方法

• 批准号: 8945949
• 负责人: KENNETH JAMES SHER
• 金额: $ 47.66万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-05 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8945949
• 关键词: Address; Alcohol consumption; Alcohol withdrawal syndrome; Alcoholism; Alcohols; Algorithms; Behavior Therapy; Benchmarking; Classification; Clinical; Clinical Data; Cognitive; Communities; Comorbidity; Computational Science; Computer software; Consumption; Country; Data; Data Analyses; Data Set; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Diagnostic and Statistical Manual of Mental Disorders; Disease; Documentation; Drug usage; Epidemiology; Evaluation; Goals; Gold; Gross National Product; Health; Heavy Drinking; Income; Individual; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10); Lead; Measurement; Methodology; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Outcome; Outcome Study; Participant; Performance; Pharmaceutical Preparations; Prevalence; Property; Psychometrics; Public Health; Publications; Publishing; Relative (related person); Research; Research Personnel; Sampling; Science; Site; Societies; Solutions; Strategic Planning; Structure; Substance Use Disorder; Surveys; Symptoms; Techniques; Treatment outcome; Validation; Withdrawal; Work; alcohol related problem; alcohol use disorder; base; clinical practice; clinically relevant; cost; craving; data sharing; density; economic cost; genetics of alcoholism; high risk; improved; innovation; instrument; interest; joint function; mortality; novel strategies; population based; programs; public health relevance; response; statistics; theories; trait; user-friendly

 DESCRIPTION (provided by applicant): Excessive alcohol use has many negative health consequences, including higher risk of mortality. In addition, the estimated economic cost of excessive drinking is more than 1% of the gross national product in high- income and middle-income countries (Rehm et al., 2009). The over-arching goal of this application is to improve the definition and assessment of alcohol use disorder (AUD). Our proposal is consistent with the goals outlined in the most recent NIAAA Strategic Plan (2009-2014). Most broadly, our study will develop and validate optimal diagnostic criteria sets and algorithms (ODCSAs) for the diagnosis of AUD that we anticipate will perform substantially better than existing diagnostic criteria (i.e. DSM-5 and ICD-10). We will employ emerging methods and develop and apply new methods in statistics and classification science to existing large population-based epidemiological data sets (the National Epidemiological Survey of Alcoholism and Related Conditions, NESARC; the National Longitudinal Alcohol Epidemiologic Survey, NLAES; the National Survey on Drug Use and Health, NSDUH), a large multi-site sample enriched for high density of AUDs (the Collaborative Study on the Genetics of Alcoholism, COGA), a major, multi-site treatment outcome study (Combining Medications and Behavioral Interventions; COMBINE) and two smaller non-clinical and clinical data sets spanning a decade or more of participants lives in order to refine assessment methods, diagnostic criteria, and diagnostic algorithms for AUDs. Specifically, by employing state-of-the art techniques in data harmonization and computational statistics, we will identify those criteria sets and decision rules that will optimize the associaton with heaviness of alcohol consumption, both within and across data sets. These new ODCSAs will then be subjected to extensive evaluation of their structural validity and external validity. n addition, we will conduct extensive validation analyses of DSM-5, ICD-10, and draft ICD-11 criteria, because these are of interest in their own right, and because that will allow us to benchmark our new ODCSAs with the current standards. We believe the development of empirically-based diagnosis for AUD will improve research on the causes and correlates of AUD and should lead to improved diagnostic criteria for clinical practice. The methods developed for this application should have broad applicability for developing diagnostic criteria or assessment instruments for a range of clinically important constructs when there are no clear "gold standards." The proposed research exploits increased availability of data sharing, new developments in data harmonization, and advances in computational science.

 描述（应用程序提供）：过度使用饮酒会带来许多负面的健康后果，包括更高的死亡风险。此外，过量饮酒的估计经济成本超过了高收入和中等收入国家的国民生产总值的1％以上（Rehm等，2009）。该应用程序的总结目标是改善酒精使用障碍的定义和评估（AUD）。我们的提议与最新的NIAAA战略计划（2009-2014）中概述的目标一致。最广泛的是，我们的研究将开发和验证最佳的诊断标准集和算法（ODCSA），以示诊断AUD，我们期望的是，我们的性能将比现有的诊断标准（即DSM-5和ICD-10）更好。 We will employ emerging methods and develop and apply new methods in statistics and classification science to existing large population-based epidemiological data sets (the National Epidemiological Survey of Alcoholism and Related Conditions, NESARC; the National Longitudinal Alcohol Epidemiological Survey, NLAES; the National Survey on Drug Use and Health, NSDUH), a large multi-site sample enriched for high density of AUDs (the Collaborative Study on the酒精中毒的遗传学，COGA），一项主要的多站点治疗结果研究（结合）药物和行为干预措施；组合）和两个较小的非临床和临床数据集，涵盖了十年或更多的参与者，以优化AUDS的评估方法，诊断标准和诊断算法。具体而言，通过在数据协调和计算统计中采用最先进的技术，我们将确定这些标准集和决策规则，这些标准集和决策规则将在数据集内和跨数据集内使用酒精消费的天堂优化协会。然后，这些新的ODCSA将对它们的结构有效性和外部有效性进行广泛的评估。 n此外，我们将对DSM-5，ICD-10和ICD-11标准草案进行广泛的验证分析，因为这些分析本身就是他们感兴趣的，因为这将使我们能够使用当前标准为我们的新ODCSA进行基准测试。我们认为，基于经验的AUD诊断的发展将改善对AUD的原因和相关性的研究，并应提高临床实践的诊断标准。为本应用开发的方法应具有广泛的可用性，以开发诊断标准或评估工具，以在没有明确的“黄金标准”时为一系列临床上重要的结构。拟议的研究利用了数据共享的可用性，数据协调方面的新发展以及计算科学的进步。