Validating a DSM-5 Substance Use Disorder (SUD) Symptom Checklist in EHR Data from a Large Primary Care Sample to Support Future Pragmatic Trials and Chronic Care Management of SUDs in Primary Care

Primary care (PC) is well-positioned to detect and address substance use (SU) and substance use disorders (SUDs), yet most PC settings have notable gaps in providing SU-related care. This study proposes to leverage a large and novel EHR dataset from Kaiser Permanente Washington, which includes standardized measures of daily cannabis use (~19,089 unique patients) and past-year illicit drug use (~6,045 unique patients), or both (~2,380 unique patients) and a novel patient-reported SUD symptom checklist that is based on the DSM-5 SUD criteria (“DSM-5 checklist”). The aim of this study is to evaluate whether the novel patient-reported DSM-5 SUD symptom checklist, used in routine PC documentation in EHRs, is unidimensional, discriminative, and reflects a continuum of SUD severity. Additionally, the study will evaluate the DSM-5 SUD symptom checklist profiles with age, sex, race, and ethnicity justifications.