Brian D'Onofrio

IU researcher utilizing computer adaptive testing to better identify those with, and at risk for, substance use disorder

One of the largest barriers for treatment for people with substance use disorder is the fast and effective identification of those in need of interventions or preventive services in primary care centers, behavioral health agencies, emergency departments and the criminal justice system.

But the current methods of detecting the need for services are cumbersome, have low reliability, and fail to detect individuals with substance use disorders or those at great risk for developing them.

Brian D’Onofrio, professor of psychological and brain sciences, is working to address that issue through computer adaptive testing.

Part of IU's Responding to the Addictions Crisis Grand Challenge, D’Onofrio and his team are working to disseminate computer adaptive testing of substance use disorders; identify its predictors and co-occurring problems to enable community agencies to quickly and accurately identify patients with existing substance use disorder; predict those at great risk for substance use disorder; and understand co-occurring mental health problems that must be addressed to reduce substance use disorder.

As part of his work, D’Onofrio is partnering with multiple community organizations, hospitals and state agencies to implement computer adaptive testing for behavioral health problems in children and adults.

Utilizing recent advances in computerized adaptive testing based on item response theory — a family of mathematical models that explain the relationship between unobservable characteristics and their observed outcomes — D’Onofrio has partnered with University of Chicago professor Robert Gibbons, who has developed a new approach to computer adaptive testing item response theory.

Via assessments using computer tablets, computer adaptive testing helps primary care clinics for adults, pediatric clinics, behavioral health clinics, criminal justice settings, and emergency department workers quickly and effectively screen for substance use and mental health problems.

D’Onofrio's team conducts interviews within the settings to identify the facilitators and barriers to implementing the standardized screening, offers training and workflow management, and provides the computers. They are now assessing the implementation of the screening, which is having immediate clinical and research implications.

The ultimate goal is to help behavioral health and other healthcare providers better identify people who are most at risk of, or are starting to develop, substance use disorders and refer them to the best services.