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Table 1 Substance use Measures/Scales identified in Systematic Review and Meta-analyzed

From: Psychometric properties of measures of substance use: a systematic review and meta-analysis of reliability, validity and diagnostic test accuracy

Scale Name Full Scale Abbreviation No. of Unique Studiesa Description
SELF-REPORTED MEASURES
Alcohol Dependence Scale ADS 3 The Alcohol Dependence Scale (ADS) is an alcohol screening and assessment tool that provides a quantitative index for the severity of alcohol dependence. Developed with respect to the concept of alcohol dependence syndrome, the ADS is comprised of 25 items that assess withdrawal symptoms, alcohol tolerance, awareness of dependence, ability to control drinking, and the salience of drink-seeking behavior.
Addiction Severity Index ASI 4 The Addiction Severity Index (ASI) is a structured interview for assessing alcohol and drug dependence. The ASI comprises 200 items across seven scales assessing past 30-day and lifetime alcohol use, drug use, medical problems, employment/support problems, legal problems, family/social problems, and psychological problems.
Addiction Severity Index-Alcohol (alcohol sub-scale) ASI-A 22 The Addiction Severity Index – Alcohol (ASI-A) is the alcohol sub-scale of the Addiction Severity Index. It assesses frequency of past 30-day and lifetime alcohol use and intoxication, alcohol-related problems including withdrawal symptoms, and treatment experiences.
Addiction Severity Index-Drugs (drugs sub-scale) ASI-D 20 The Addiction Severity Index – Drugs (ASI-D) is the drug sub-scale of the Addiction Severity Index. It assesses frequency of past 30-day and lifetime use of 10 drug classes (heroin, methadone, other opiates/analgesics, barbiturates, other sedatives/hypnotics/tranquilizers, cocaine, amphetamines, cannabis, hallucinogens, and inhalants), drug-related problems including overdose, and treatment experiences.
The Alcohol, Smoking, and Substance Involvement Screening Test ASSIST 8 The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a tool developed by the World Health Organization to screen for risky use of alcohol, tobacco and other drugs. It comprises items measuring past three-month and lifetime frequency of use of tobacco products, alcohol and illicit drugs (cannabis, cocaine, amphetamine-type stimulants, inhalants, sedatives/sleeping pills, hallucinogens, opioids, other drugs) and related health, social, legal and financial problems.
Alcohol Use Disorders Identification Test AUDIT 127 The Alcohol Use Disorders Identification Test (AUDIT) is a ten-question test developed by a World Health Organization-sponsored collaborative project to identify persons with hazardous and harmful patterns of alcohol consumption or alcohol dependence. It comprises questions on amount and frequency of alcohol consumed, alcohol dependence, and alcohol-related problems.
Alcohol Use Disorders Identification Test - Question 3 AUDIT-3 16 The Alcohol Use Disorders Identification Test – 3 (AUDIT-3) is a brief alcohol screening instrument. Derived from the third question of the ten-item AUDIT developed by the World Health Organization, it consists of a single-item measure assessing heavy episodic drinking.
Alcohol Use Disorders Identification Test - C AUDIT-C 42 The Alcohol Use Disorders Identification Test - Concise (AUDIT-C) is a brief alcohol screening instrument derived from the first three questions of the ten-item AUDIT developed by the World Health Organization. It assesses frequency of alcohol consumption, number of standard drinks consumed on a typical drinking day, and frequency of consumption of six or more drinks on one occasion.
Brief Michigan Alcoholism Screening Test B-MAST 12 Adapted from the original Michigan Alcohol Screening Test (MAST), the Brief Michigan Alcohol Screening Test (B-MAST) is a shortened 10-item alcohol use questionnaire that aims to identify alcohol dependence. The 10 items assess the presence or absence of negative consequences as a result of drinking through yes or no self-reported responses.
Cut down, Annoyed, Guilty, Eye-opener CAGE 98 CAGE is a four-item measure designed to identify problem drinking. The four items assess whether an individual has ever felt the need to cut down on their drinking, been annoyed by others’ criticism of their drinking, felt guilty about drinking, or felt the need to have a drink first-thing in the morning to steady their nerves or get rid of a hangover.
Composite International Diagnostic Interview CIDI Original version: 2; Version 2.1: 2; Version 3: 2 The Composite International Diagnostic Interview (CIDI) is a structure interview developed by the World Health Organization to assess psychiatric disorders based on International Statistical Classification of Diseases and Related Health Problems (ICD) definitions and Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria.
Car, Relax, Alone, Forget, Friends, Trouble CRAFFT 11 The Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) questionnaire is screening tool to identify substance use problems among adolescents.
Drug Abuse Screen Test DAST 10 The Drug Abuse Screen Test (DAST) is a 28-item questionnaire parallel to those of the Michigan Alcoholism Screening Test (MSM) to screen for drug use problems and consequences.
Drug Abuse Screen Test – 10 item DAST-10 8 The Drug Abuse Screen Test – 10 item (DAST-10) is a shorten version of the DAST screening test. It is used to assess problems and consequences related to substance use.
Drug Use Disorders Identification Test DUDIT 12 The Drug Use Disorders Identification Test (DUDIT), designed as a parallel instrument to the AUDIT, is an 11-item self-administered screening instrument for drug-related problems. It assesses use patterns of use and various drug-related problems.
Michigan Alcohol Screening Test MAST 22 The Michigan Alcohol Screening Test (MAST) is a 25-item scale designed to assess lifetime symptoms of alcoholism with a focus on late-stage symptoms.
Problem Oriented Screening Instrument for Teenagers POSIT 3 The Problem Oriented Screening Instrument for Teenagers (POSIT) is a self-administer screening questionnaire comprised of 139 items which screen for potential problems in 10 domains including Substance use and abuse; Physical health; Mental health; Family relations; Peer relations; Educational status; Vocational status; Social skills; Leisure/recreation; and Aggressive behavior.
Self-Administered Alcoholism Screening Test SAAST 4 The Self-Administered Alcoholism Screening Test (SAAST) is a 35-item questionnaire to screen for alcohol dependence. It assesses problem related to alcohol in the following domains: loss of control, occupational and social disruption, physical consequences, emotional consequences, concern on the part of others, and family members with alcohol problems.
Semi-Structured Assessment for Drug Dependence and Alcoholism SSADDA 1 The Semi-structured Assessment for Drug Dependence and Alcoholism (SSADDA) is a screening instrument that assesses alcohol/drug abuse and dependence as well as other DSM-IV disorders throughout the lifetime. It was developed from the Semi-Structured Assessment for the Genetics of Alcoholism, and therefore includes questions on the onset and recency of individual alcohol/drug abuse and dependence symptoms, allowing temporal assessment of symptom clusters. Its format as a semi-structured interview lists questions to be read verbatim, but also allows the interviewer to add follow-up questions.
Severity of Dependence SDS 9 The Severity of Dependence Scale (SDS) is a 5-item questionnaire used to measure the degree of dependence on different classes of drugs, with a focus on the psychological components of dependence.
Tolerance-Annoyance Cut Down Eye Opener TACE 9 Tolerance-Annoyance Cut Down Eye Opener (TACE) is a 4-item screening tool to identify maternal prenatal problematic alcohol use.
Timeline Followback TLFB 5 The Timeline Followback (TLFB) is a method that involves the use of a timeline (e.g., calendar) to ask individuals to estimate their daily alcohol and/or drug use consumption retrospectively (e.g., 7 days, 2 years).
Tolerance, Worried, Eye-Opener, Amnesia, Cut down TWEAK 17 Originally developed as an alcohol screening tool for periconceptional risk in obstetric outpatients, TWEAK, is a 5-item questionnaire that seeks to identify harmful drinking. The 5-items are comprised of questions from the MAST, CAGE, and T-ACE screening tools and cover tolerance, worry, eye-opener, amnesia, k/cut-down (which make up the acronym TWEAK). TWEAK is primarily used as an efficient method to determine whether or not the risk or presence of harmful drinking should be further assessed and/or treated.
The Chemical Use, Abuse, and Dependence CUAD 1 The Chemical Use, Abuse, and Dependence (CUAD) is a semi-structure interview that can measure substance use severity and substance use disorders.
BIOMARKERS
% Carbohydrate deficient transferrin %CDT 35 Carbohydrate-deficient transferrin (CDT) is an alcohol biomarker that is used as a clinical screening and monitoring tool to identify heavy drinking. Transferrin is glycoprotein produced in the liver that normally has 3–5 carbohydrate side chains. Heavy alcohol use, however, inhibits the enzymes involved to appropriately regulate these side chains; causing the transferrin to be carbohydrate deficient. A %CDT reading ≥2.6 indicates that a participant may have had on average at least 5 alcoholic drinks daily for ≥2 weeks. Laboratory blood test can detect elevated levels of CDT (%CDT), which are indicative of heavy alcohol consumption and often used to detect relapses.
Alanine transaminase ALT 26 Alanine aminotransferase (ALT) is a biomarker, which indicates liver damage from different types of disease and conditions. It that is used as a clinical screening and monitoring tool to check for chronic alcohol use. ALT is an enzyme found mostly in the cells of the liver and kidney. When the liver is damaged, ALT is released into the blood. Elevated ALT in laboratory tests is indicative of heavy alcohol consumption and often used to detect relapses.
Aspartate transaminase AST 31 Aspartate transaminase (AST) is a biomarker, which indicates liver damage from different types of disease and conditions. It that is used as a clinical screening and monitoring tool to check for chronic alcohol use. The concentrations of AST in the serum are normally low. However, if the liver is damaged, the liver cell (hepatocyte) membrane becomes more permeable and some of the enzymes leak out into the blood circulation. Elevated AST in laboratory tests are indicative of chronic alcohol abuse
Aspartate transaminase, Alanine transaminase ratio AST/ALT 5 AST and ALT are considered to be two of the most important tests to detect liver injury. The ALT: AST ratio is normally and in other condition is less than 1, but becomes greater than unity during liver injury. Elevated AST/ALT in laboratory tests are indicative of chronic alcohol abuse.
Blood alcohol concentration BAC 5 Blood Alcohol Concentration (BAC) levels represent the percent of your blood that is concentrated with alcohol. It is most commonly used as a metric of alcohol intoxication for legal or medical purposes. Its primary goal is to determine if alcohol has been consumed.
Carbohydrate deficient transferrin CDT 9 Carbohydrate-deficient transferrin (CDT) is an alcohol biomarker that is used as a clinical screening and monitoring tool to identify heavy drinking. Transferrin is glycoprotein produced in the liver that normally has 3–5 carbohydrate sidechains. Heavy alcohol use, however, inhibits the enzymes involved to appropriately regulate these sidechains; causing the transferrin to be carbohydrate deficient. Laboratory blood test can detect elevated levels of CDT (%CDT), which are indicative of heavy alcohol consumption and often used to detect relapses.
CDTech CDTech 35 Description: CDTect is a common method of using carbohydrate-deficient transferrin (CDT) to screen for heavy alcohol use.
Carbohydrate deficient transferrin + Mean corpuscular volume CDT + MCV 5 Carbohydrate-deficient transferrin (CDT) and Mean corpuscular volume (MCV) are two biomarkers commonly used to screen for heavy drinking. MCV is the average volume of blood cells, which increase in size after 4 to 8 weeks of excessive alcohol intake. CDT is transferrin, a glycoprotein produced in the liver that has become carbohydrate deficient. Heavy alcohol use prevents enzymes from properly regulating the carbohydrate side chains in transferrin, thus increasing the value of carbohydrate-deficient transferrin. Using the combined biomarkers of CDT and MCV, a patient must exceed the cut-off of both biomarkers to be screened positive.
Gamma-Glutamyl Transferase GGT 68 Gamma-Glutamyl Transferase (GGT) is an enzyme that when elevated in serum is reflective of liver damage. Subsequently, clinical laboratory GGT tests are commonly used to detect and monitor excessive alcohol consumption. Elevated GGT levels typically correspond with continuous and chronic alcohol abuse as opposed to episodic heavy drinking.
Gamma-Glutamyl Transferase + Mean corpuscular volume GGT + MCV 10 Gamma-Glutamyl Transferase (GGT) and Mean corpuscular volume (MCV) are two biomarkers commonly used in screening heavy alcohol intake. GGT is a type of enzyme that, when elevated in serum, is reflective of liver damage. MCV is the average volume of red blood cells, which increases after 4 to 8 weeks of excessive drinking. Used in combination, a patient must exceed the cut-offs for both GGT and MCV in order to be screened positive.
Ethyl glucuronide EtG 5 Ethyl glucuronide (EtG) is a byproduct of the body’s metabolization of alcohol, and can be detected in the hair for up to 90 days. Compared to a blood or urine analysis, a hair analysis for EtG provides a much longer window of detection for heavy alcohol consumption.
Mean corpuscular volume MCV 51 Mean corpuscular volume (MCV) is the average volume of red blood cells, measured by multiplying a volume of blood by the proportion of the blood that is cellular, and then dividing the product by the number of red blood cells within that sample. The size of red blood cells increase after 4 to 8 weeks of excessive alcohol intake, making MCV effective as an alcohol biomarker. MCV is not very sensitive as a standalone measure or specific in detecting alcohol relapse, as it is slow to return to a normal value. It is, however, an easy and affordable method of testing.
Phosphatidylethanol PEth 8 Phosphatidylethanol (PEth), a commonly used alcohol biomarker, is an abnormal group of phospholipids that are formed in red blood cells only in the presence of alcohol. Clinical laboratory tests can identify the presence of PEth in blood, which is indicative of alcohol abuse. PEth testing is a popular detection tool for heavy alcohol consumption because it is considered a direct biomarker for ethanol and has 99% sensitivity.
  1. Note:aSome studies contributed more than one data point/were comprised of more than on study populations. References for studies, by scale/measure, are presented in Supplementary Table 2