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Biomedical subjects

D Rindskopf

Publications and source records attributed to D Rindskopf.

5 recordsLinked to original sources
PubMed2001

The visibility of illicit drugs: implications for community-based drug control strategies.

OBJECTIVES: This study examined differences between the visibility of drugs and drug use in more than 2100 neighborhoods, challenging an assumption about drug use in poor, minority, and urban communities. METHODS: A telephone survey assessed substance use and attitudes across 41 communities in an evaluation of a national community-based demand reduction program. Three waves of data were collected from more than 42 000 respondents. RESULTS: Measures of neighborhood disadvantage, population density, and proportion of minority residents explained more than 57% of the variance between census tracts in visibility of drug sales but less than 10% of tract-to-tract variance in drug use. Visible drug sales were 6.3 times more likely to be reported in the most disadvantaged neighborhoods than in the least disadvantaged, while illicit drug use was only 1.3 times more likely. CONCLUSIONS: The most disadvantaged neighborhoods have the most visible drug problems, but drug use is nearly equally distributed across all communities. Thus, efforts to address drug-related problems in poorer areas need to take into account the broader drug market served by these neighborhoods.

Adolescent↗
PubMed1998

Zero effects in substance abuse programs. Avoiding false positives and false negatives in the evaluation of community-based programs.

The evaluation of community-based programs poses special design and analysis problems. The present article focuses on two major types of errors that can occur in such evaluations: false positive--incorrectly declaring a program to be effective--and false negatives--incorrectly declaring a program to be ineffective. The evaluation of a national demonstration of community-based programs to reduce substance abuse, Fighting Back, is used to illustrate several approaches to reduce the probability of errors. Both those errors that are affected by the design and those by analytic approaches are considered. Ways to assess multiple outcomes and to match the complexity of the program with design and analytic strategies are proposed. Community trials are complex interventions, and, although they can provide very useful information, their outcomes have to be understood in terms of the constructs they test and the contexts within which they are carried out.

Adolescent↗
PubMedDate not supplied

The value of latent class analysis in medical diagnosis.

Assessment of the value of diagnostic indicators such as symptoms and laboratory tests results from calculation of the sensitivity and specificity of the indicators. Knowledge of the rate of occurrence of the disease allows for additional calculations of the error rates in using an indicator. These calculations are accurate only when the data on which they are based are reliable. If the diagnosis, which is used as the criterion for computing the sensitivity and specificity, is not accurate, then the resulting calculations will be in error. We show how a statistical method, latent class analysis, allows for the estimation of the characteristics of indicators even when an accurate diagnosis is unavailable. In addition, the method deals with several indicators at once, and provides a way to combine the information from all the indicators to make a diagnosis.

Biometry↗
PubMedDate not supplied

Survey estimates of drug-use trends in urban communities: general principles and cautionary examples.

Surveys to depict substance abuse rates and monitor trends in specific areas have become increasingly important policy tools. Yet, as illustrated by two national multiwave surveys, using small sample survey data and making longitudinal comparisons is fraught with interpretative problems. In the case of the metropolitan area "oversample" of the National Household Survey on Drug Abuse, for example, interpreting apparent declines in drug use has to take account of the devastating effects of Hurricane Andrew in the Miami Metropolitan area. In the case of a 41-community survey sponsored by the Robert Wood Johnson Foundation to evaluate substance abuse prevention, the difficulty is how to interpret small differences in drug use, which seem to follow no reasonable pattern with respect to treatment or comparison sites. Inferences from such surveys are confounded with statistical anomalies and unforeseen events. They are limited by the sample size. In part, the solution to these problems is to use other survey and nonsurvey data to validate their conclusions and to note their limitations.

Confounding Factors, Epidemiologic↗