Reliabilities of short substance abuse screening tests among adolescent medical patients.
OBJECTIVE
To determine the internal consistency and 1-week test-retest reliability of the Simple Screening Instrument for Alcohol and Other Drug Abuse (SSI-AOD), the CAGE-AA (CAGE questions adapted for adolescents), and 4 modified items from the Drug and Alcohol Problem QuickScreen (DAP-4) among adolescents.


METHODS
Fifteen- to 18-year-old medical patients (n = 173) completed screening tests during a routine medical visit and then again 1 week later. Internal consistency for each test and retest was calculated using Cronbach's alpha, and 1-week test-retest reliability was calculated by using Winer's unbiased estimate of the intraclass correlation coefficient (r).


RESULTS
The SSI-AOD has good internal consistency (alpha =.83) and the CAGE-AA questions acceptable internal consistency (alpha =.60). Alpha varied with gender and race, and item analysis indicated the CAGE-AA test could be improved. As expected, the DAP-4 had a lower alpha score (.46). All screening instruments studied had high 1-week test-retest reliabilities (range r =.82-.90).


CONCLUSIONS
The SSI-AOD is a reliable substance abuse screening instrument among adolescent medical patients. The CAGE-AA questions must be further revised and tested before their use can be recommended. The DAP-4 questions are likely measuring different, but important, constructs.
Knight
J R
JR
Division on Addictions and Department of Pediatrics, Harvard Medical School, Division of General Pediatrics, Children's Hospital, Boston, Massachusetts 02115, USA. knight_j@hub.tch.harvard.edu
Goodman
E
E
Pulerwitz
T
T
DuRant
R H
RH
D000293:Adolescent; D000428:Alcohol Drinking; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D015203:Reproducibility of Results; D015813:Substance Abuse Detection