The Addiction Severity Index medical and psychiatric composite scores measure similar domains as the SF-36 in substance-dependent veterans: concurrent and discriminant validity.
BACKGROUND
Recently attention has focused on the assessment of functional health status in substance-dependent individuals. The addiction severity index (ASI) is a widely used assessment instrument that includes scales to reflect current medical and psychiatric status. This study examines the concurrent validity of these ASI composite scores in relation to the short form 36-item health survey (SF-36), a well-established measure of health-related quality of life/functional health status.


METHODS
Veterans (n=674) were assessed at admission to substance dependence treatment. Correlations were performed between ASI composite scores and SF-36 scales and the physical and mental summary components (PSC and MSC, respectively). Areas under receiver operating characteristic (ROC) curves determined the descriminative ability of the ASI composites to ascertain impairment.


RESULTS
The ASI medical composite score demonstrated robust correlations with the four SF-36 scales that relate to physical health and with the PCS. The ASI psychiatric composite score had robust correlations with the four SF-36 scales related to mental health and with the mental component summary (MCS). ROC curves indicated that the ASI medical (AUC=0.83) and psychiatric composites (AUC=0.90) accurately detected subjects with impairment.


CONCLUSIONS
ASI medical and psychiatric composite scores provide effective initial screening for patients with impaired functional status as measured by the corresponding SF-36 component summary scores.
VA Puget Sound Health Care System, Center of Excellence in Substance Abuse Treatment and Education, 1660 S Columbian Way, Seattle, WA 98108, USA. donald.calsyn@med.va.gov
Donald A
DA
Calsyn
Andrew J
AJ
Saxon
Kristen R
KR
Bush
Donelle N
DN
Howell
John S
JS
Baer
Kevin L
KL
Sloan
Carol A
CA
Malte
Daniel R
DR
Kivlahan
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D012017:Referral and Consultation; D015203:Reproducibility of Results; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*