Agreement between self-reported illicit drug use and biological samples: A systematic review and meta-analysis
Abstract
BACKGROUND AND AIMS
Studies often rely on self-report and biological testing methods for measuring illicit drug use, yet evidence for their agreement is limited to specific populations and self-report instruments. We aimed to examine comprehensively the evidence for agreement between self-reported and biologically measured illicit drug use across all major illicit drug classes, biological indicators, populations, and settings.
METHODS
We systematically searched peer-reviewed databases (Medline, Embase, and PsycINFO) and grey literature. Included studies reported 2x2 table counts or agreement estimates comparing self-reported and biologically measured use published up to March 2022. With biological results considered the reference standard and use of random effect regression models, we evaluated pooled estimates for overall agreement (primary outcome), sensitivity, specificity, false omission rates (proportion reporting no use that test positive) and false discovery rates (proportion reporting use that test negative) by drug class, potential consequences attached to self-report (i.e., work, legal or treatment impacts), and timeframe of use. Heterogeneity was assessed by inspecting forest plots. The study protocol was registered with PROSPERO, CRD42020182499.
RESULTS
From 7,924 studies, we extracted data from 207 eligible studies. Overall agreement ranged from good to excellent (>0.79). False omission rates were generally low while false discovery rates varied by setting.…
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