title: Validation of the 4P's Plus screen for substance use in pregnancy validation of the 4P's Plus.
abstract: OBJECTIVE
  The purpose of this study is to validate the 4P's Plus screen for substance use in pregnancy.
  
  
  METHODS
  A total of 228 pregnant women enrolled in prenatal care underwent screening with the 4P's Plus and received a follow-up clinical assessment for substance use. Statistical analyses regarding reliability, sensitivity, specificity, and positive and negative predictive validity of the 4Ps Plus were conducted.
  
  
  RESULTS
  The overall reliability for the five-item measure was 0.62. Seventy-four (32.5%) of the women had a positive screen. Sensitivity and specificity were very good, at 87 and 76%, respectively. Positive predictive validity was low (36%), but negative predictive validity was quite high (97%). Of the 31 women who had a positive clinical assessment, 45% were using less than 1 day per week.
  
  
  CONCLUSIONS
  The 4P's Plus reliably and effectively screens pregnant women for risk of substance use, including those women typically missed by other perinatal screening methodologies.
authors.affiliation: Children's Research Triangle, Chicago, IL 60601, USA. ichasnoff@cr-triangle.org
authors.forename: I J
authors.initials: IJ
authors.lastname: Chasnoff
authors.forename: A M
authors.initials: AM
authors.lastname: Wells
authors.forename: R F
authors.initials: RF
authors.lastname: McGourty
authors.forename: L K
authors.initials: LK
authors.lastname: Bailey
mesh_terms: D000328:Adult; D000434:Alcoholic Beverages; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008403:Mass Screening / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis*