Cognitive impairment is common in individuals with substance use disorders (SUDs), yet no evidence-based guidelines exist regarding the most appropriate screening measure for use in this population. This systematic review aimed to (1) describe different cognitive screening measures used in adults with SUDs, (2) identify substance use populations and contexts these tools are utilised in, (3) review diagnostic accuracy of these screening measures versus an accepted objective reference standard, and (4) evaluate methodology of included studies for risk of bias.

Online databases (PsycINFO, MEDLINE, Embase, and CINAHL) were searched for relevant studies according to pre-determined criteria, and risk of bias and applicability was assessed using the Quality Assessment of Diagnostic Accuracy Studies–2 (QUADAS–2). At each review phase, dual screening, extraction, and quality ratings were performed.

Fourteen studies met inclusion, identifying 10 unique cognitive screening tools. The Montreal Cognitive Assessment (MoCA) was the most common, and two novel screening tools (Brief Evaluation of Alcohol-Related Neuropsychological Impairments [BEARNI] and Brief Executive Function Assessment Tool [BEAT]) were specifically developed for use within SUD populations. Twelve studies reported on classification accuracy and relevant psychometric parameters (e.g., sensitivity and specificity). While several tools yielded acceptable to outstanding classification accuracy, there was poor adherence to the Standards for Reporting Diagnostic Accuracy Studies (STARD) across all studies, with high or unclear risk of methodological bias.

While some screening tools exhibit promise for use within SUD populations, further evaluation with stronger methodological design and reporting is required. Clinical recommendations and future directions for research are discussed.

认知障碍在物质使用障碍 (SUD) 患者中很常见，但目前尚无关于在该人群中使用的最合适筛查措施的循证指南。本系统评价旨在 (1) 描述在患有 SUD 的成人中使用的不同认知筛查措施，(2) 确定使用这些工具的物质使用人群和环境，(3) 对照公认的客观参考标准审查这些筛查措施的诊断准确性(4) 评估纳入研究的偏倚风险方法。

根据预先确定的标准在在线数据库（PsycINFO、MEDLINE、Embase 和 CINAHL）中搜索相关研究，并使用诊断准确性研究质量评估-2（QUADAS-2）评估偏倚风险和适用性。在每个审查阶段，都进行了双重筛选、提取和质量评级。

十四项研究符合纳入标准，确定了 10 种独特的认知筛查工具。蒙特利尔认知评估 (MoCA) 是最常见的，并且专门开发了两种新的筛查工具（酒精相关神经心理障碍的简要评估 [BEARNI] 和简要执行功能评估工具 [BEAT]）用于 SUD 人群。十二项研究报告了分类准确性和相关的心理测量参数（例如，敏感性和特异性）。虽然有几种工具的分类准确性可以接受，但所有研究对报告诊断准确性研究标准 (STARD) 的依从性较差，方法学偏倚的风险很高或不明确。

虽然一些筛选工具显示出在 SUD 人群中使用的前景，但需要通过更强大的方法设计和报告进行进一步评估。讨论了临床建议和未来的研究方向。