Predictive and convergent validity of the ASAM criteria software in Norway

Abstract

The ASAM Criteria Software from the American Society of Addiction Medicine is a new computer-assisted structured interview and clinical decision support program that implements validated tools such as the Addiction Severity Index (ASI), and measures biopsychosocial conditions to match patients to an optimal level of care (LOC). The study methods involved a prospective, double-blind, multi-site, naturalistic study of substance use disordered treatment seekers. We analyzed: (1) discrepancies in ASAM Criteria LOC recommendations versus Treatment-as-Usual (TAU), (2) the software's ability to clinically distinguish between patients with different LOC (convergent validity) and (3) predictive validity. Results indicated that the discrepancies in TAU LOC recommendations versus the Software were in line with previous research. Baseline comparisons using ASI Composite Subscale scores (CSs) showed better agreement with the ASAM LOC recommendations versus TAU. Finally, the ASAM recommendations were associated with better outcomes three months later for the matched versus mis-matched groups. These results confirmed the Software's convergent validity as well as predictive validity. These outcomes are promising and suggest that programs should avoid both under- and over-matching patients. Future, both national and international studies, should include the full complement of LOC specified in the ASAM Criteria, properly characterized, with larger samples.

• ASAM criteria
• optimal placement
• level of care
• drug and alcohol
• SUD treatment
• assessment