Development and validation of a virtual agent to screen tobacco and alcohol use disorders
Drug and Alcohol Dependence. 2018-12-01; 193: 1-6
DOI: 10.1016/j.drugalcdep.2018.08.025
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Auriacombe M(1), Moriceau S(2), Serre F(2), Denis C(3), Micoulaud-Franchi JA(4), de Sevin E(5), Bonhomme E(5), Bioulac S(4), Fatseas M(2), Philip P(4).
Author information:
(1)University of Bordeaux, Bordeaux, France; SANPSY, CNRS USR 3413, Bordeaux,
France; Pôle Addictologie, CH Charles Perrens and Unité de Soins Complexes
d’addictologie (USCA) CHU de Bordeaux, Bordeaux, France; Center for Studies of
Addiction, Department of Psychiatry, Perelman School of Medicine, University of
Pennsylvania, Phildelphia, PA, USA. Electronic address:
.
(2)University of Bordeaux, Bordeaux, France; SANPSY, CNRS USR 3413, Bordeaux,
France; Pôle Addictologie, CH Charles Perrens and Unité de Soins Complexes
d’addictologie (USCA) CHU de Bordeaux, Bordeaux, France.
(3)SANPSY, CNRS USR 3413, Bordeaux, France; Center for Studies of Addiction,
Department of Psychiatry, Perelman School of Medicine, University of
Pennsylvania, Phildelphia, PA, USA.
(4)University of Bordeaux, Bordeaux, France; SANPSY, CNRS USR 3413, Bordeaux,
France; Clinique du sommeil, CHU de Bordeaux, Bordeaux, France.
(5)University of Bordeaux, Bordeaux, France; SANPSY, CNRS USR 3413, Bordeaux,
France.
Background
Substance use disorders are under-detected and not systematically diagnosed or screened for by primary care. In this study, we present the acceptability and validity of an Embodied Conversational Agent (ECA) designed to screen tobacco and alcohol use disorder, in individuals who did not seek medical help for these disorders.
Methods
Individuals were included from June 2016 to May 2017 in the Outpatient Sleep Clinic of the University Hospital of Bordeaux. DSM-5 diagnoses of tobacco and alcohol use disorders were assessed by human interviewers. The ECA interview integrated items from the Cigarette Dependence Scale-5 (CDS-5) for tobacco use disorder screening, and the “Cut Down, Annoyed, Guilty, Eye-opener” (CAGE) questionnaire for alcohol use disorder screening. Paper version of CDS-5 and CAGE questionnaires and acceptability questionnaire was also self-administered.
Results
Of the 139 participants in the study (mean age 43.0 (SD = 13.7) years), 71 were women, and 68 were men. The ECA was well accepted by the patients. Paper self-administered CDS-5 and CAGE scores had a strong agreement with the ECA (p < 0.0001). The Receiver Operating Characteristic (ROC) analysis of the ECA interview showed AUC of 0.97 (95% CI, 0.93–1.0) and 0.84 (95% CI, 0.69–0.98) for CDS-5 and CAGE respectively with p-value <0.0001.
Conclusions
This ECA was acceptable and valid to screen tobacco or alcohol use disorder among patients not requesting treatment for addiction. The ECA could be used in hospitals and potentially in primary care settings to help clinicians to better screen their patients for alcohol and tobacco use disorders.