Addiction Medicine Practice-Based Research Network (AMNet): Assessment Tools and Quality Measures

Figures & data

Figure 1 AMNet Standardized Assessment Tool Selection Flowchart.

Abbreviations: *BAM, Brief Addiction Monitor ; COWS, Clinical Opiate Withdrawal Scale; TEA, Treatment Effectiveness Assessment; **C-SSRS, Columbia-Suicide Severity Rating Scale.

Table 1 AMNet Assessment Tools

Tier	Tool Name	Description	Domain(s)	Psychometric Properties Reported
I	Tobacco, Alcohol, Prescription Medications, and other Substances (TAPS) Tool^Citation49	A 4-item screen for tobacco, alcohol, illicit drugs, and non-medical prescription drugs, followed by a substance-specific assessment of risk level of individuals who screen positive	Consumption	Good sensitivity and specificity for identifying any problem use of tobacco (0.93 and 0.87, respectively) and alcohol (0.74 and 0.79, respectively); sensitivity for identifying problem use of illicit and prescription drugs (ranged from 0.63 to 0.82) and specificity was 0.93 or higher; 99% of participants in the study found the TAPS Tool to be acceptable^Citation49
	Brief Addiction Monitor (BAM)^Citation22	A 17-item screen to assess risk factors associated with relapse or worsening addiction severity, protective factors associated with the initiation and maintenance of sobriety and use of alcohol and other substances	Consumption, sleep, quality of life, and recovery	Good test–retest reliability for three summary factors (ICC ≥ 0.75); predictive validity demonstrated for two summary factors (p˂0.05)a,^Citation22
	PhenX Cigarette Smoking Status^Citation50	A 4-item self-rated tool that assesses cigarette smoking status	Consumption	Demonstrated face validity due to selection of items by a panel of experts in the scientific community and inclusion as common data element for assessing substance use by NIDA^Citation20
	PhenX Injection Drug Use measure^Citation51	A 7-item self-rated tool that assesses injection drug use	Consumption; prescription opioid misuse	Demonstrated face validity due to selection of items by a panel of experts in the scientific community and inclusion as common data element for assessing substance use by NIDA^Citation20
	Treatment Effectiveness Assessment (TEA)^Citation25	A 4-item self-rated tool that assesses patient’s progress in treatment and in recovery. Collects patients’ responses on their substance use, health, lifestyle, and community	Recovery	Excellent internal consistency (Cronbach α= 0.9); moderate test-retest reliability (ICC=0.69); sensitive to change in current health status (when compared to the first item of the SF-36)b,^Citation25
	Short Opiate Withdrawal Scale (SOWS- Gossop)^Citation52	A 10-item screening tool used to evaluate patient-rated opioid withdrawal symptom severity	Withdrawal	Good test-retest reliability (ICC ranged from 0.78–0.88); good to excellent internal consistency (Cronbach α ranged from 0.86–0.9)^Citation53
	Single-item Visual Analog Scale (VAS)^Citation54	A subjective quantification of the level of craving experienced by marking a point on a line	Craving	Very strong convergent validity with DDQ (r =0.76, p < 0.05) c,^Citation54
	Patient Health Questionnaire (PHQ)-2+1^Citation55	A 3-item tool screens for depression and suicidal ideation	Mental health including suicide ideation	Good sensitivity and specificity for diagnosis of major depression (0.86 and 0.78, respectively)^Citation55
II	Clinical Opiate Withdrawal Scale (COWS)^Citation56	An 11-item scale designed to be used in both inpatient and outpatient settings to rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time	Withdrawal	Acceptable internal consistency (Cronbach α= 0.78); very strong concurrent validity with CINA (r=0.85; p<0.001)^Citation57
	PHQ-9^Citation58	9-item multipurpose instrument for screening. diagnosing, monitoring, and measuring the severity of depression	Mental health	Good internal consistency (Cronbach α= 0.89); excellent test-retest reliability (α ≥0.9); good to excellent criterion validity (sensitivity and specificity ranged from 0.68 to 0.95); very strong construct validity (r=0.73) with mental health subscale of SF-20^Citation58
	Columbia-Suicide Severity Rating Scale (C-SSRS+)^Citation28	Suicidal ideation and behavior rating scale	Suicide ideation (ie, mental health)	Excellent internal consistency (Cronbach α ranged from 0.94 to 0.95); strong convergent validity (r ranged from 0.52 to 0.56, p<0.001) with the Scale for Suicide Ideation; Good divergent validity (with items on BDI and MADRS); predictive validity^Citation28
	PROMIS Pain Interference Instrument -Adult Short^Citation59	Measures self-reported consequences of pain or relevant aspects of person’s life. Universal rather than diseases specific. Provides a patient perspective on the extent to which pain interferes in activities of daily living	Pain-related functioning	Good to excellent Internal Consistency (Cronbach’s α ranged from 0.93 to 0.96) strong to very strong construct validity (r = 0.69 to 0.76) with PROMIS Anxiety Short Form and PROMIS Depression Short Form^Citation60

Notes: ^aInterpretation of ICC values: ICC˂0.5=poor, 0.5≤ICC˂0.75=moderate, 0.75≤ICC˂0.9=good, and ICC≥0.90=excellent.⁶¹ bInterpretation of α values: α˂0.5 = unacceptable; 0.5≤α˂0.6=poor; 0.6≤α˂0.7= questionable; 0.7≤α˂0.8=acceptable; 0.8≤α˂0.9=good; α≥0.9=excellent.⁶² cInterpretation of r values: 0= no relationship; 0.01–0.19=No/negligible relationship; 0.20–0.29=weak positive relationship; 0.03–0.39=moderate positive relationship; 0.40–0.69=strong positive relationship; 0.70 or higher=very strong relationship.⁶³

Abbreviations: ICC, intraclass correlation coefficient; NIDA, National Institute on Drug Abuse; SF, Short Form Health Survey; DDQ, Desires for Drug Questionnaire; r, Pearson’s correlation coefficient; CINA, Clinical Institute Narcotic Assessment; BDI, Beck Depression Inventory; MADRS, Montgomery-Åsberg Depression Rating Scale.

Figure 2 AMNet Quality Measure Selection Flowchart.

Abbreviations: *OUD, opioid use disorder; **CCI, Center for Care Innovations.

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