BACKGROUND Timeline Follow-back (TLFB) interviews using self-report are often used to assess substance use. Oral fluid testing (OFT) offers an objective measure of substance use. There are limited data on the agreement between TLFB and OFT. METHODS In this secondary analysis from a multisite study in five primary care sites, self-reported TLFB and OFT data collected under confidential conditions were compared to assess concordance (N=1799). OFT samples were analyzed for marijuana, heroin, cocaine, and non-medical use of prescription opioids. Demographic differences in discordance relative to TLFB and OFT concordant results for marijuana, the only substance with an adequate sample size in this analysis, were examined using multinomial logistic regression. RESULTS Overall concordance rates between TLFB and OFT were 94.9 % or higher for each substance, driven by large subgroups with no use. Among participants with discordant use, marijuana was the only substance with lower detection on OFT than self-report (27.6 % OFT-positive only vs 32.2 % TLFB-positive only), whereas cocaine (65.6 % vs 8.6 %), prescription opioids (90.4 % vs 6.0 %), and heroin (40.7 % vs 26.0 %) all had higher detection via OFT than TLFB. Participants who reported marijuana use but had a negative OFT were more likely to be younger, Hispanic, and White compared to those with TLFB and OFT concordant positive results. CONCLUSIONS TLFB and OFT show disparate detection of different substances. Researchers should consider the implications of using either self-report or oral fluid testing in isolation, depending on the substance and collection setting. Triangulating multiple sources of information may improve detection of drug use.

中文翻译：

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时间线追踪自我报告和口服液测试在成人初级保健患者中检测药物使用的比较。

背景技术使用自我报告的时间轴跟踪（TLFB）访谈通常用于评估药物使用情况。口服液测试（OFT）提供了一种客观的物质使用量度。TLFB和OFT之间的协议的数据有限。方法在来自五个主要护理场所的多场所研究的次要分析中，比较了在保密条件下收集的自我报告的TLFB和OFT数据，以评估一致性（N = 1799）。分析了OFT样品中的大麻，海洛因，可卡因和处方阿片类药物的非医疗用途。相对于TLFB和OFT大麻的一致结果而言，不一致的人口统计学差异是本次分析中唯一具有足够样本量的物质，使用多项逻辑回归分析。结果TLFB与OFT之间的总体一致性率为94。每种物质的9％或更高的含量，是由大型子组驱动而没有使用的。在使用不协调的参与者中，大麻是唯一在OFT中检出率低于自我报告的物质（仅OFT阳性为27.6％，而TLFB阳性仅为32.2％），而可卡因（65.6％对8.6％）是处方阿片类药物（90.4 ％和6.0％），以及海洛因（40.7％和26.0％）通过OFT的检测均高于TLFB。与TLFB和OFT一致阳性结果的受试者相比，报告使用大麻但OFT阴性的受试者更年轻，西班牙裔和白人。结论TLFB和OFT对不同物质的检测不同。研究人员应根据物质和采集设置，考虑单独使用自我报告或口服液体测试的含义。