Screening, brief intervention, and referral to treatment (SBIRT) approaches to reducing hazardous alcohol and illicit drug use have been assessed in a variety of health care settings, including primary care, trauma centers, and emergency departments. A major methodological concern in these trials, however, is “assessment reactivity,” the hypothesized impact of intensive research assessments to reduce alcohol and drug use and thus mask the purported efficacy of the interventions under scrutiny.
Assessment reactivity is a potential source of bias that may reduce and/or lead to an underestimation of the purported effectiveness of brief interventions. From a methodological perspective, it needs to be accounted for in research design. This article in Addiction Science & Clinical Practice, by Pacific Northwest Node PI Dennis Donovan and colleagues, describes the design of the National Drug Abuse Treatment Clinical Trials Network (CTN) protocol, “Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments” (SMART-ED, CTN-0047), which addresses the potential bias of assessment reactivity using a 3-arm design.
The SMART-ED design offers an approach to minimize assessment reactivity as a potential source of bias. Elucidating the role of assessment reactivity may offer insights into the mechanisms underlying SBIRT as well as suggest clinical options incorporating assessment reactivity as a treatment adjunct.
Citation: Donovan DM, Bogenschutz MP, Perl HI, et al. Study Design to Examine the Potential Role of Assessment Reactivity in Screening, Motivational Assessment, Referral and Treatment in Emergency Departments (SMART-ED) Protocol. Addiction Science & Clinical Practice 2012;7:16.