International Journal of General Medicine (Nov 2022)
Development and Validation of a Self-Administered Screening Test for Betel Quid Use Disorders in Betel Quid Chewers in Hunan, China
Abstract
Lei Yang,1,2 Weimin Dang,2,3 Xin Yu,1,2 Yi He,4,5 Chuan Shi,1,2 Jialong Yi,1,2 Lu Gao,6 Siheng Li,7 Tianhang Zhou,1,2 Yantao Ma1,2 1Department of Clinical Research, Peking University Sixth Hospital (Institute of Mental Health), Beijing, People’s Republic of China; 2NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China; 3The Division of Medical Affairs, Peking University Sixth Hospital (Institute of Mental Health), Beijing, People’s Republic of China; 4Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, People’s Republic of China; 5Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China; 6Department of Stomatology, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China; 7Department of Neurology, Peking University First Hospital, Beijing, People’s Republic of ChinaCorrespondence: Xin Yu, Peking University Sixth Hospital, No. 51 Hua Yuan Bei Road, Haidian District, Beijing, 100191, People’s Republic of China, Tel +86 13718747842, Fax +86-10-62026310, Email [email protected]: Processed betel quid product chewing is a public health problem in areca non-plant areas in China. However, there is no valid instrument to screen for betel quid use disorder (BQUD) in mainland China. We developed a self-administered screening test for betel quid use disorders (SST-BQUD) and tested its reliability and validity in a sample of betel quid chewers (BQCers) in Hunan, China.Methods: Items of SST-BQUD were selected from the test results of an item pool, which includes 52 questions related to the psycho-social and behavioral presentations of BQUD. All participants, in a self-administered manner, completed the item pool. A subsample completed the re-test one week later. Two psychiatrists interviewed all participants to ascertain the presence of BQUD. The receiver Operating Characteristic curve was used to determine the best cut-off value to discriminate BQUD.Results: One hundred and twelve BQCers were recruited. Based on the statistical analysis of receiver operating characteristic (ROC) curves, 14 yes/no questions were selected for SST-BQUD. As indicated by Cronbach’s α coefficient, the internal consistency was 0.876. The area under the curve of SST-BQUD was 0.881, representing a satisfactory diagnostic value. The one-week re-test reliability test was 0.771 (P< 0.001), suggesting good stability over time. The optimal cut-off score for BQUD screening was six, with a sensitivity of 0.921 and a specificity of 0.716, implying the satisfactory accuracy of SST-BQUD to screen for BQUD.Conclusion: The standard version of SST-BQUD consists of 14 items. The total score of SST-BQUD was the sum of affirmative answers, with higher scores denoting a more severe BQUD symptom. If one answered six or more times “yes” to these 14 questions, they can be classified with BQUD. The SST-BQUD is a valid screening method for BQUD among BQCers in betel quid processed area.Keywords: betel quid use disorders, screener, development, validity, diagnostic test
