Temporal and gender trends in concordance of urine drug screens and self-reported use in cocaine treatment studies

Megan S. Schuler, William V. Lechner, Rickey E. Carter, Robert Malcolm

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: To describe temporal trends in concordance, sensitivity, and specificity and to explore demographic trends in concordance in 2 outpatient treatment studies for cocaine dependence. Methods: We obtained 2229 urine drug screens (UDS) from 129 individuals, along with accompanying self-use reports (SUR). Paired SUR and UDS were considered concordant if the 2 measures of cocaine use were in agreement. The sensitivity and specificity of the SUR in predicting the UDS was also estimated. To model concordance, sensitivity, and specificity as a function of time, generalized estimating equations were used. Demographic effects on concordance among subjects who achieved 100% concordance and subjects who achieved a recently proposed 70% concordance threshold were tested. Results: During the course of our studies, both sensitivity and concordance statistically decreased; however, specificity remained relatively constant. Median concordance for all subjects was 88%. Among all subjects, concordance varied significantly by gender, with women achieving significantly higher concordance than men (96% vs 86%). Similarly, women were almost twice as likely to achieve 100% concordance as men (42% vs 22%). Finally, 80% of participants achieved the 70% concordance threshold, and no differences among demographic groups with regards to the 70% concordance threshold were observed. Conclusions: Temporal effects of concordance and sensitivity may have profound repercussions when using SUR to gauge efficacy of an experimental intervention. Furthermore, gender may differentially affect concordance. Finally, a substance abuse outcome measure that reliably combines objective and self-report data is promising, but further research is needed.

Original languageEnglish (US)
Pages (from-to)211-217
Number of pages7
JournalJournal of Addiction Medicine
Volume3
Issue number4
DOIs
StatePublished - Dec 2009
Externally publishedYes

Fingerprint

Cocaine
Self Report
Urine
Pharmaceutical Preparations
Demography
Sensitivity and Specificity
Therapeutics
Cocaine-Related Disorders
Substance-Related Disorders
Outpatients
Outcome Assessment (Health Care)
Research

Keywords

  • Cocaine
  • Concordance
  • Gender
  • Sensitivity
  • Temporal effects

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Temporal and gender trends in concordance of urine drug screens and self-reported use in cocaine treatment studies. / Schuler, Megan S.; Lechner, William V.; Carter, Rickey E.; Malcolm, Robert.

In: Journal of Addiction Medicine, Vol. 3, No. 4, 12.2009, p. 211-217.

Research output: Contribution to journalArticle

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