PMID- 38227856
OWN - NLM
STAT- MEDLINE
DCOM- 20240314
LR  - 20240314
IS  - 1935-3227 (Electronic)
IS  - 1932-0620 (Linking)
VI  - 18
IP  - 2
DP  - 2024 Mar-Apr 01
TI  - Evidence of "Repeated Admission Bias" Among Those Who Use Injection Drugs Across 
      2 Decades of US Treatment Admissions: 2000-2020.
PG  - 201-204
LID - 10.1097/ADM.0000000000001265 [doi]
AB  - OBJECTIVES: Encounter-based datasets like the Treatment Episode 
      Dataset-Admissions (TEDS-A) are used for substance use-related research. Although 
      TEDS-A reports the number of previous treatment admissions, a limitation is this 
      reflects encounters, not people. We sought to quantify the methodologic bias 
      incorporated by using all encounters versus initial encounters and assess if this 
      risk is evenly distributed across all routes of drug administration. METHODS: 
      TEDS-A 2000-2020 dataset with nonmissing primary substance data was used. Of the 
      data, 3.17% were missing the usual administration route, and 11.9% were missing 
      prior admission data. Prior admissions are documented as 0 through 4, then binned 
      for 5 or greater (5+). Risk of admission bias was defined as odds ratio (OR RAB 
      ): odds of total admissions relative to the odds of the first admission. 
      Bootstrap confidence intervals were generated (5000 iterations) across 
      administration routes and demographics; however, their widths were <0.0055 and 
      not reported. RESULTS: There were 38,238,586 admissions over the 21 years, with 
      13,865,517 (41.2%) first admissions. Of all admissions, 15.7% indicated injection 
      drug use (IDU); 26.3% of encounters reporting IDU were in the 5+ group. This 
      resulted in an OR RAB of 1.77. White enrollees had an elevated OR RAB (1.05), 
      whereas among Latinos, OR RAB was low (0.74). CONCLUSIONS: Using encounter-based 
      datasets can introduce bias when including all admissions versus exclusively 
      initial treatment episodes. This report is the first to quantify this bias and 
      shows that individuals with IDU are at highest risk for returning to treatment, 
      thereby over-representing this method of use when all encounters are used.
CI  - Copyright (c) 2024 American Society of Addiction Medicine.
FAU - Bormann, Nicholas L
AU  - Bormann NL
AD  - From the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA 
      (NLB); Department of Psychiatry, University of Iowa, Iowa City, IA (SA); and 
      Department of Biostatistics, University of Iowa, Iowa City, IA (SA).
FAU - Arndt, Stephan
AU  - Arndt S
LA  - eng
PT  - Journal Article
DEP - 20240115
PL  - Netherlands
TA  - J Addict Med
JT  - Journal of addiction medicine
JID - 101306759
SB  - IM
MH  - Humans
MH  - *Hospitalization
MH  - *Substance-Related Disorders
MH  - Bias
COIS- The authors report no conflicts of interest.
EDAT- 2024/01/16 18:41
MHDA- 2024/03/14 06:46
CRDT- 2024/01/16 15:33
PHST- 2024/03/14 06:46 [medline]
PHST- 2024/01/16 18:41 [pubmed]
PHST- 2024/01/16 15:33 [entrez]
AID - 01271255-990000000-00266 [pii]
AID - 10.1097/ADM.0000000000001265 [doi]
PST - ppublish
SO  - J Addict Med. 2024 Mar-Apr 01;18(2):201-204. doi: 10.1097/ADM.0000000000001265. 
      Epub 2024 Jan 15.