Are opioid use disorder assessments in the emergency department biased? An examination across sex, race, and employment status using item response theory.

Autor: Himes KP; Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA. Electronic address: khimes@ttu.edu., Dan Petrovitch MA; Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA., Freiermuth CE; Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, USA; Center for Addiction Research, University of Cincinnati, Cincinnati, OH, USA., Bachmann DJ; Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA., Bischof JJ; Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA., Braun RS; Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, USA., Brown JL; Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA., Frey JA; Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA., Lyons MS; Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA., Pantalon MV; Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA., Punches BE; Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA; College of Nursing, The Ohio State University, Columbus, OH, USA., Sprague JE; The Ohio Attorney General's Center for the Future of Forensic Science, Bowling Green State University, Bowling Green, OH, USA., Littlefield AK; Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA.
Jazyk: angličtina
Zdroj: General hospital psychiatry [Gen Hosp Psychiatry] 2024 Nov-Dec; Vol. 91, pp. 186-189. Date of Electronic Publication: 2024 Nov 17.
DOI: 10.1016/j.genhosppsych.2024.11.007
Abstrakt: Background: In acute care settings such as the emergency department (ED), the absence of test bias is essential for any assessment. Unbiased assessments of the DSM-5 criteria for opioid use disorder (OUD) are crucial to ensure valid comparison of OUD severity, though focused tests of potential bias are lacking.
Method: This study used item response theory (IRT) to examine potential test bias across patient characteristics (i.e., sex, race, employment status) in a sample of 518 individuals aged 18+ who reported opioid use within the prior 12 months. Participants indicated the presence or absence of the 11 DSM-5 OUD criteria, as well as self-reported demographic information.
Results: IRT indicated a lack of test bias (i.e., measurement invariance) for DSM-5 OUD across biological sex, race, and employment status. The lack of test bias permitted the groups to be compared on OUD severity across demographic groups. Males, White individuals, and unemployed individuals reported higher OUD severity.
Conclusions: Findings indicate the DSM-5 OUD criteria are unbiased across sex, race, and employment status. Thus, these criteria can be used in the ED to compare differences in OUD severity across key demographic groups. The current study provides empirical support for using OUD assessments in ED settings to inform in-vivo clinical decisions across different sexes, races, and employment statuses. Future studies are needed to corroborate this finding in additional samples and across additional demographic characteristics (e.g., ethnicity, age).
Competing Interests: Declaration of competing interest The following authors received compensation for time spent on the parent study through awards to their institutions from the Ohio Attorney General Office: Rob Braun, Drs. Freiermuth, Bischof, Bachmann, Brown, Frey, Lyons, and Punches. Drs. Littlefield and Pantalon received compensation for the parent study through consultant payments. Author Pantalon reports grants and personal fees from Center for Progressive Recovery, LLC, of which he is a cofounder, outside the submitted work. Author Punches is funded by NIDA K08DA049948. Authors Himes, Petrovitch, and Sprague have nothing to disclose.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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