Table 1.

Screening instruments evaluated in the present study.

Screening instrument	Original reference standard	Cut score (published)	Performance in original study (sensitivity/specificity)
Substance Use Risk Profile–Pregnancy (SURP-P) [20]	Past 30-day use, per self-report	2	0.57/0.88
10. Have you ever smoked marijuana?
20. In the month before you knew you were pregnant, how many beers, how much wine, or how much liquor did you drink?
30. Have you ever felt that you needed to cut down on your drug or alcohol use?
Wayne Indirect Drug Use Screener (WIDUS) [5]	Urine and hair (dichotomous)	3	0.68/0.69a
10. I am currently married
20. In the past year, I have been bothered by pain in my teeth or mouth
30. I have smoked at least 100 cigarettes in my entire life
40. Most of my friends smoke cigarettes
50. There have been times in my life, for at least 2 weeks straight, where I felt like everything was an effort
60. I get mad easily and feel a need to blow off some steam
CRAFFT questionnaire [21,22]	Calendar recall	2	NAb
10. Have you ever ridden in a car driven by someone (including yourself) who was ‘high’ or had been using alcohol or drugs?
20. Do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?
30. Do you ever use alcohol/drugs while you are by yourself, alone?
40. Do you ever forget things you did while using alcohol or drugs?
50. Do your family or friends ever tell you that you should cut down on your drinking or drug use?
60. Have you ever gotten into trouble while you were using alcohol or drugs?
5Ps questionnaire [23]
10. Did any of your parents have a problem with using alcohol or drugs?
20. Do any of your friends have a problem with drug or alcohol use?
30. Does your partner have a problem with drug or alcohol use?
40. Before you knew you were pregnant, how often did you drink beer, wine, wine coolers or liquor?
50. In the past month, how often did you drink beer, wine, wine coolers or liquor?		1
NIDA Quick Screen [25–32]	Dependence (CIDI)c	1
10. In the past year,d how often have you had four or more drinks a day?			0.88/0.84
20. In the past year,d how often have you used tobacco products?			0.97/0.79
3. In the past year,d how often have you used prescription drugs for non-medical reasons?
4. In the past year,d how often have you used illegal drugs?

^aFrom cross-validation sample.

^bSensitivity and specificity for CRAFFT (acronym for five-item screener with items related to car, relax, alone, forget, friends and trouble) with pregnant women not available; 5Ps = parents, peers, partner, pregnancy, past.positive predictive value (PPV) = 0.90, negative predictive value (NPV) = 0.80, area under the curve (AUC) = 0.90.

^cAccuracy statistics are available for the alcohol and drug questions of the NIDA Quick Screen but not the tobacco or prescription drug misuse items. CIDI = Composite International Diagnostic Interview.

^dThe NIDA Quick Screen uses a ‘past-year’ time-frame. Because women tend to reduce substance use during pregnancy, this study used a past-month time-frame.