Table 3.
Performance of single-question screener for past-year drug-use disorder and drug use: U.S. adults 18 years and older with past-year ED utilization
| Drug dependence |
Drug-use disorder (abuse and/or dependence) |
Drug use |
||||||||||
| Freq. of drinking 5+/4+ drinks | % Sens | % Spec. | % PPV | PLR | % Sens. | % Spec. | % PPV | PLR | % Sens. | % Spec. | % PPV | PLR |
| Any illicit drug | ||||||||||||
| ≥Once a year | 70.4 (5.5 | 74.9 (0.7) | 4.3 (0.6) | 2.8 (0.2) | 71.5 (3.5) | 75.8 (0.7) | 9.5 (0.8) | 3.0 (0.2) | 65.4 (2.3) | 78.1 (0.7) | 22.6 (1.3) | 3.0 (0.1) |
| ≥3 times a year | 64.4 (5.6) | 79.6 (0.7) | 4.9 (0.7) | 3.2 (0.3) | 67.4 (3.5) | 80.6 (0.7) | 10.9 (1.0) | 3.5 (0.2) | 58.5 (2.3) | 82.6 (0.6) | 24.8 (1.5) | 3.4 (0.2) |
| ≥7 times a year | 62.7 (5.9) | 83.0 (0.6) | 5.6 (0.8) | 3.7 (0.4) | 65.6 (3.6) | 83.9 (0.6) | 12.6 (1.1) | 4.1 (0.3) | 54.9 (2.4) | 85.9 (0.6) | 27.6 (1.7) | 3.9 (0.2) |
| ≥Once a month | 61.1 (5.8) | 84.9 (0.5) | 6.1(0.9) | 4.0 (0.4) | 60.1 (3.7) | 85.7 (0.5) | 12.9 (1.2) | 4.2 (0.3) | 50.7 (2.4) | 87.6 (0.5) | 28.6 (1.8) | 4.1 (0.3) |
| ≥Twice a month | 57.1 (5.8) | 87.5 (0.5) | 6.9 (1.1) | 4.6 (0.5) | 56.4 (3.8) | 88.3 (0.5) | 14.6 (1.4) | 4.8 (0.4) | 43.7 (2.3) | 89.8 (0.5) | 29.6 (2.0) | 4.3 (0.3) |
| ≥Once a week | 47.8 (6.0) | 90.1 (0.5) | 7.2 (1.3) | 4.8 (0.7) | 46.8 (4.1) | 90.7 (0.4) | 15.1 (1.7) | 5.0 (0.5) | 36.7 (2.3) | 92.0 (0.4) | 31.1 (2.2) | 4.6 (0.4) |
| Area under ROC curve (AUC) | MLE binormal AUC = .806, 95% CI [.752, .852] | MLE binormal AUC = .823, 95% CI [.793, .850] | MLE binormal AUC = .805, 95% CI [.784, .824] | |||||||||
| Marijuana | ||||||||||||
| ≥Once a year | 77.9 (6.8) | 74.6 (0.7) | 2.2 (0.5) | 3.1 (0.3) | 76.2 (4.0) | 75.4 (0.7) | 6.7 (0.7) | 3.1 (0.2) | 73.8 (2.5) | 77.2 (0.7) | 16.9 (1.2) | 3.2 (0.1) |
| ≥3 times a year | 70.7 (7.0) | 79.3 (0.7) | 2.5 (0.5) | 3.4 (0.4) | 71.8 (3.9) | 80.1 (0.7) | 7.7 (0.8) | 3.6 (0.2) | 66.0 (2.60) | 81.7 (0.6) | 18.5 (1.4) | 3.6 (0.2) |
| ≥7 times a year | 67.7 (8.1) | 82.6 (0.6) | 2.8 (0.6) | 3.9 (0.5) | 69.6 (4.1) | 83.4 (0.6) | 8.9 (1.0) | 4.2 (0.3) | 62.8 (2.7) | 85.1 (0.6) | 20.9 (1.5) | 4.2 (0.2) |
| ≥Once a month | 65.4 (8.2) | 84.5 (0.5) | 3.0 (0.7) | 4.2 (0.5) | 62.7 (4.4) | 85.2 (0.5) | 9.0 (1.0) | 4.2 (0.3) | 57.2 (2.8) | 86.7 (0.5) | 21.3 (1.7) | 4.3 (0.3) |
| ≥Twice a month | 60.7 (8.2) | 87.2 (0.5) | 3.4 (0.8) | 4.7 (0.7) | 59.1 (4.6) | 87.9 (0.5) | 10.2 (1.2) | 4.9 (0.4) | 50.6 (2.8) | 89.2 (0.5) | 22.6 (1.8) | 4.7 (0.3) |
| ≥Once a week | 51.1 (8.4) | 89.8 (0.5) | 3.5 (1.0) | 5.0 (0.9) | 49.2 (4.9) | 90.4 (0.5) | 10.6 (1.4) | 5.1 (0.6) | 43.2 (2.8) | 91.5 (0.4) | 24.2 (2.1) | 5.1 (0.4) |
| Area under ROC curve (AUC) | MLE binormal AUC = .851, 95% CI [.800, .893] | MLE binormal AUC = .853, 95% CI [.825, .878] | MLE binormal AUC = .846, 95% CI [.827, .863] | |||||||||
| Cocaine/crack | ||||||||||||
| ≥Once a year | 80.8 (13.2) | 74.4 (0.7) | 1.1 (0.3) | 3.2 (0.5) | 73.7 (11.2) | 74.5 (0.7) | 1.7 (0.4) | 2.9 (0.4) | 74.8 (7.7) | 74.7 (0.7) | 3.1 (0.6) | 3.0 (0.3) |
| ≥3 times a year | 74.7 (13.6) | 79.1 (0.7) | 1.2 (0.4) | 3.6 (0.7) | 68.7 (11.3) | 79.2 (0.7) | 2.0 (0.5) | 3.3 (0.6) | 71.6 (7.8) | 79.5 (0.7) | 3.7 (0.7) | 3.5 (0.4) |
| ≥7 times a year | 74.7 (13.6) | 82.4 (0.6) | 1.5 (0.4) | 4.2 (0.8) | 68.7 (11.3) | 82.5 (0.6) | 2.3 (0.6) | 3.9 (0.7) | 71.6 (7.8) | 82.8 (0.6) | 4.3 (0.8) | 4.2 (0.5) |
| ≥Once a month | 74.7 (13.6) | 84.4 (0.5) | 1.7 (0.5) | 4.8 (0.9) | 66.8 (11.2) | 84.5 (0.5) | 2.5 (0.6) | 4.3 (0.7) | 68.3 (7.9) | 84.7 (0.5) | 4.6 (0.9) | 4.5 (0.5) |
| ≥Twice a month | 70.1 (13.7) | 87.0 (0.5) | 1.9 (0.6) | 5.4 (1.1) | 64.1 (11.2) | 87.1 (0.5) | 2.9 (0.7) | 5.0 (0.9) | 62.8 (7.6) | 87.4 (0.5) | 5.1 (1.0) | 5.0 (0.6) |
| ≥Once a week | 67.4 (13.9) | 89.7 (0.5) | 2.2 (0.7) | 6.5 (1.4) | 62.5 (11.4) | 89.8 (0.5) | 3.6 (0.9) | 6.1 (1.2) | 58.9 (7.6) | 90.0 (0.5) | 6.0 (1.2) | 5.9 (0.8) |
| Area under ROC curve (AUC) | MLE binormal AUC = .875, 95% CI [.762, .944] | MLE binormal AUC = .880, 95% CI [.812, .929] | MLE binormal AUC = .880, 95% CI [.840, .913] | |||||||||
| Any illicit rx drug | ||||||||||||
| ≥Once a year | 57.7 (9.1) | 74.5 (0.7) | 1.7 (0.4) | 2.3 (0.4) | 62.5 (6.0) | 74.8 (0.7) | 3.6 (0.5) | 2.5 (0.2) | 59.8 (3.1) | 76.0 (0.7) | 11.7 (0.9) | 2.5 (0.1) |
| ≥3 times a year | 52.2 (9.0) | 79.2 (0.7) | 1.9 (0.4) | 2.5 (0.4) | 57.9 (6.0) | 79.5 (0.7) | 4.0 (0.6) | 2.8 (0.3) | 53.5 (3.1) | 80.7 (0.6) | 12.8 (1.1) | 2.8 (0.2) |
| ≥7 times a year | 51.6 (9.0) | 82.5 (0.6) | 2.2 (0.5) | 2.9 (0.5) | 57.0 (6.0) | 82.8 (0.6) | 4.7 (0.7) | 3.3 (0.4) | 51.1 (3.2) | 84.0 (0.6) | 14.5 (1.2) | 3.2 (0.2) |
| ≥Once a month | 48.1 (8.7) | 84.4 (0.5) | 2.2 (0.6) | 3.1 (0.6) | 53.9 (6.0) | 84.7 (0.5) | 5.0 (0.8) | 3.5 (0.4) | 47.8 (3.2) | 85.8 (0.5) | 15.2 (1.3) | 3.4 (0.3) |
| ≥Twice a month | 43.1 (8.6) | 87.0 (0.5) | 2.5 (0.6) | 3.3 (0.7) | 49.5 (6.2) | 87.4 (0.5) | 5.5 (1.0) | 3.9 (0.5) | 40.9 (3.1) | 88.3 (0.5) | 15.7 (1.5) | 3.5 (0.3) |
| ≥Once a week | 34.1 (8.1) | 89.6 (0.5) | 2.4 (0.6) | 3.3 (0.8) | 42.1 (6.4) | 89.9 (0.5) | 5.9 (1.1) | 4.2 (0.7) | 34.3 (3.2) | 90.7 (0.4) | 16.4 (1.7) | 3.7 (0.4) |
| Area under ROC curve (AUC) | MLE binormal AUC = .746, 95% CI [.654, .829] | MLE binormal AUC = .765, 95% CI [.701, .821] | MLE binormal AUC = .753, 95% CI [.719, .785] | |||||||||
Notes: Figures in parentheses represent standard errors of estimates. Shaded cells denote cutpoints that result in highest combined values of sensitivity (sens.) and specificity (spec), with sens, constrained to be above 60% if possible. Freq. = frequency; PPV = positive predictive value; PLR = positive likelihood ratio; ROC = receiver operator characteristic; AUC = area under receiver-operator characteristic curve; MLE = maximum likelihood estimation; CI = confidence interval; rx = prescription.