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Abstract：
BACKGROUND: Psychoactive drug use is an important public health issue in Sri Lanka as it causes substantial health, social and economic burden to the country. Screening for substance use disorders in people who use drugs is vital in preventive health care, as it can help to identify problematic use early. Screening can aid in referring those in need, for the most appropriate treatment and care. Thus, preventing them from developing severe substance use disorders with complications. The Drug Abuse Screening Test (DAST-10) is an evidence-based tool widely used to assess the severity of psychoactive drug use. This study aimed to culturally adapt and evaluate the validity and reliability of the Drug Abuse Screening Test (DAST-10) in Sri Lanka.
METHODS: The DAST-10 was culturally adapted, and the nine-item Sinhala version (DAST-SL) was validated using exploratory and confirmatory factor analysis. The validation study was conducted in the Kandy district among people who use drugs, recruited using respondent-driven sampling. Criterion validity of the questionnaire was assessed by taking the diagnosis by a psychiatrist as the gold standard. Cut-off values for the modified questionnaire were developed by constructing Receiver Operating Characteristic (ROC) curves. The reliability of the DAST-SL was assessed by measuring its internal consistency and test re-test reliability.
RESULTS: The validated DAST-SL demonstrated a one-factor model. A cut-off value of ≥ 2 demonstrated the presence of substance use disorder and had a sensitivity of 98.7%, specificity of 91.7%, a positive predictive value of 98.8% and a negative predictive value of 91.3%. The area under the curve of the ROC curve was 0.98. A cut-off score of ≤ 1 was considered a low level of problems associated with drug use. The DAST-SL score of 2-3 demonstrated a moderate level of problem severity, a score of 4-6 demonstrated a substantial level of problems, and a score of ≥ 7 demonstrated a severe level of drug-related problems. The questionnaire demonstrated high reliability with an internal consistency of 0.80 determined by Kuder-Richardson Formula-20 and an inter-class correlation coefficient of 0.97 for test re-test reliability.
CONCLUSIONS: The DAST-SL questionnaire is a valid and reliable tool to screen for drug use problem severity in people who use drugs in Sri Lanka.
METHODS: The DAST-10 was culturally adapted, and the nine-item Sinhala version (DAST-SL) was validated using exploratory and confirmatory factor analysis. The validation study was conducted in the Kandy district among people who use drugs, recruited using respondent-driven sampling. Criterion validity of the questionnaire was assessed by taking the diagnosis by a psychiatrist as the gold standard. Cut-off values for the modified questionnaire were developed by constructing Receiver Operating Characteristic (ROC) curves. The reliability of the DAST-SL was assessed by measuring its internal consistency and test re-test reliability.
RESULTS: The validated DAST-SL demonstrated a one-factor model. A cut-off value of ≥ 2 demonstrated the presence of substance use disorder and had a sensitivity of 98.7%, specificity of 91.7%, a positive predictive value of 98.8% and a negative predictive value of 91.3%. The area under the curve of the ROC curve was 0.98. A cut-off score of ≤ 1 was considered a low level of problems associated with drug use. The DAST-SL score of 2-3 demonstrated a moderate level of problem severity, a score of 4-6 demonstrated a substantial level of problems, and a score of ≥ 7 demonstrated a severe level of drug-related problems. The questionnaire demonstrated high reliability with an internal consistency of 0.80 determined by Kuder-Richardson Formula-20 and an inter-class correlation coefficient of 0.97 for test re-test reliability.
CONCLUSIONS: The DAST-SL questionnaire is a valid and reliable tool to screen for drug use problem severity in people who use drugs in Sri Lanka.
摘要：
背景：精神活性药物的使用在斯里兰卡是一个重要的公共卫生问题，因为它会导致大量的健康，给国家带来社会和经济负担。在使用药物的人中筛查物质使用障碍在预防保健中至关重要，因为它可以帮助及早发现有问题的使用。筛查可以帮助推荐有需要的人，进行最合适的治疗和护理。因此，防止他们发展严重的物质使用障碍和并发症。药物滥用筛查测试（DAST-10）是一种基于证据的工具，广泛用于评估精神活性药物使用的严重程度。本研究旨在文化适应和评估斯里兰卡药物滥用筛查测试（DAST-10）的有效性和可靠性。
方法：DAST-10具有文化适应性，使用探索性和验证性因素分析对9项僧伽罗语版本（DAST-SL）进行了验证。验证研究是在康提地区的吸毒人群中进行的，使用受访者驱动的抽样招募。以精神科医生的诊断为金标准来评估问卷的标准有效性。通过构建受试者工作特征(ROC)曲线来开发修改的问卷的截止值。通过测量其内部一致性和测试再测试可靠性来评估DAST-SL的可靠性。
结果：验证的DAST-SL证明了单因素模型。临界值≥2表明存在物质使用障碍，敏感度为98.7%，特异性91.7%，阳性预测值为98.8%，阴性预测值为91.3%。ROC曲线的曲线下面积为0.98。≤1的截止分数被认为是与药物使用相关的低水平问题。2-3的DAST-SL评分显示出中等水平的问题严重程度，4-6分证明了很大的问题，评分≥7分显示严重的药物相关问题.问卷显示出高可靠性，由Kuder-RichardsonFormula-20确定的内部一致性为0.80，测试再测试可靠性的类别间相关系数为0.97。
结论：DAST-SL问卷是一种有效且可靠的工具，可用于筛查斯里兰卡吸毒人群的吸毒问题严重程度。
方法：DAST-10具有文化适应性，使用探索性和验证性因素分析对9项僧伽罗语版本（DAST-SL）进行了验证。验证研究是在康提地区的吸毒人群中进行的，使用受访者驱动的抽样招募。以精神科医生的诊断为金标准来评估问卷的标准有效性。通过构建受试者工作特征(ROC)曲线来开发修改的问卷的截止值。通过测量其内部一致性和测试再测试可靠性来评估DAST-SL的可靠性。
结果：验证的DAST-SL证明了单因素模型。临界值≥2表明存在物质使用障碍，敏感度为98.7%，特异性91.7%，阳性预测值为98.8%，阴性预测值为91.3%。ROC曲线的曲线下面积为0.98。≤1的截止分数被认为是与药物使用相关的低水平问题。2-3的DAST-SL评分显示出中等水平的问题严重程度，4-6分证明了很大的问题，评分≥7分显示严重的药物相关问题.问卷显示出高可靠性，由Kuder-RichardsonFormula-20确定的内部一致性为0.80，测试再测试可靠性的类别间相关系数为0.97。
结论：DAST-SL问卷是一种有效且可靠的工具，可用于筛查斯里兰卡吸毒人群的吸毒问题严重程度。
