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Concordance between timeline follow-back and single-question assessment of self-reported smoking in a clinical trial.

ABSTRACT: Smoking cessation clinical trials assess tobacco abstinence using self-report and biomarkers. Optimum methods for each are unclear; a common question assesses smoking in the prior 7 days. In contrast, timeline follow-back (TLFB) is another technique often used to assess use of alcohol in treatment trials; it is used less frequently in studies of smoking cessation. The goal of this study was to assess concordance between the 7-day smoking question and a 7-day TLFB.Secondary analysis of data from a randomized clinical trial of smoking cessation was conducted at a busy, urban hospital emergency department (ED) from October 2010 to December 2012. At 1, 3, and 12 months, subjects were contacted by phone to assess smoking status. Those reporting abstinence at 3 months were asked to return for an in-person measurement of exhaled carbon monoxide. For this analysis, smoking status at 1 month was compared for subjects in response to 2 questions asked concurrently, addressing 7-day point prevalence tobacco use and a 7-day TLFB.Of 780 subjects, 666 (85.4%) were available for 1-month follow-up. Of these, 99 (14.9%) reported no smoking in response to the 7-day question, and 96 (14.4%) reported no smoking in response to the 7-day TLFB. The overall proportionate agreement between the 2 methods was 98.6%, with a kappa of 0.95 (95% confidence interval [CI]: 0.91-0.98).A single question that assesses smoking at 7 days provides excellent concordance with the more detailed TLFB. The single question appears adequate to assess self-reported tobacco use in clinical trials of smoking cessation.

SUBMITTER: Bernstein SL

PROVIDER: S-EPMC5035170 | biostudies-literature | 2016 Jul-Sep

REPOSITORIES: biostudies-literature

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Concordance between timeline follow-back and single-question assessment of self-reported smoking in a clinical trial.

Bernstein Steven L SL Rosner June J Toll Benjamin B

Substance abuse 20160701 3

<h4>Background</h4>Smoking cessation clinical trials assess tobacco abstinence using self-report and biomarkers. Optimum methods for each are unclear; a common question assesses smoking in the prior 7 days. In contrast, timeline follow-back (TLFB) is another technique often used to assess use of alcohol in treatment trials; it is used less frequently in studies of smoking cessation. The goal of this study was to assess concordance between the 7-day smoking question and a 7-day TLFB.<h4>Methods</ ...[more]

PMID: 27007476

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Project description:BackgroundValidated tools for assessing alcohol use among young people in low-income countries are needed to estimate prevalence and evaluate alcohol-reduction interventions. We validated Alcohol Use Disorders Identification Test (AUDIT) against Timeline Follow Back (TLFB), Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and phosphatidylethanol (PEth); and the 30-day-AUDIT against the 12-months-AUDIT among young Ugandans.MethodsIn 2018, we collected retrospective data on 30-day and 12-month AUDIT, TLFB and DSM-5 in a cross-sectional study of 15-24?year old residents of Ugandan fishing communities. AUDIT was administered by Audio Computer Assisted Self-Interviewing (ACASI) and DSM-5 and TLFB by psychiatric nurses. We determined PEth16:0/18:1 levels from dried blood spots using liquid chromatography tandem-mass spectrometry (heavy usage, ?210?ng/mL) and calculated sensitivity and specificity of AUDIT against the other measures.ResultsAmong 1281 participants (52.7% male, mean age 20?years), half (n?=?659; 51.4%) reported ever drinking alcohol, 19.4% had 12-month-AUDIT???8 (21.5% men; 17.0% women), and 24.2% had 30-day-AUDIT???8 (29.0% men; 18.9% women). Twenty percent of participants had detectable PEth with 55 (4.3%) classified as heavy drinkers; 50.7% reported???2 symptoms on DSM-5 and 6.3% reported binge drinking in the previous month based on TLFB (8.9% men, 3.5% women). The 30-day-AUDIT???8 had sensitivity 86.7%, 95%CI: 81.8%-90.7% and specificity 90.9%, 95%CI:89.0%-92.6% versus 12-month-AUDIT???8. Both 30-day and 12-month-AUDIT???8 were sensitive and specific markers of heavy drinking by PEth (12-month-AUDIT sensitivity?=?80.0%; 95%CI:67.0%-89.6%; specificity?=?83.3%; 95%CI:81.1%-85.3%). The 30-day-AUDIT was a sensitive and specific marker of binge drinking based on TLFB (sensitivity?=?82.7%; 95%CI:72.7%-90.2%, specificity?=?79.8%; 95%CI:77.4%-82.1%); 12-month-AUDIT had lower sensitivity. Both 30-day and 12-month AUDIT???8 were highly specific but insensitive markers of having DSM-5???2 symptoms.ConclusionAmong young people in Uganda, ACASI-administered 30-day and 12-month-AUDIT have good diagnostic properties compared to PEth, DSM-5 and TLFB. Self-reported AUDIT provides a quick and valid means of assessing alcohol misuse in these communities.

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Concordance between timeline follow-back and single-question assessment of self-reported smoking in a clinical trial.

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Concordance between timeline follow-back and single-question assessment of self-reported smoking in a clinical trial.

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