Clinical Professor Dept Anesthesiology SUNY @ Buffalo
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Introduction: We have developed a Pre-Sedation Cannabis Use Score (PCUS) to stratify sedation patients with respect to their cannabis use history. We have found that the higher the score the greater the sedation requirements are and the poorer the sedation quality. The PCUS was based on the DFAQ-CU and has 25 questions. This makes it a bit cumbersome for use as a routine screening tool. The aim of this study was to develop a shorter version of the PCUS (using only 8 or 12 questions) and evaluate the accuracy of this to the full version.
Methods: After IRB approval and patent consent/assent, a 25 item questionnaire was completed prior to IV placement or sedation. The questionnaire takes about 5 minutes to complete and evaluates the timeline and type of cannabis use. The individual question results/scores were evaluated by Factor analysis to determine different “groups” of questions and their validity. After the factors were identified, those with the highest variance from each factor were chosen to create the short PCUS-8 or PCUS-12 versions. The categorization by the Full and the Q8 or Q12 scores where then compared for accuracy of the shortened versions.
Results: The questionnaires from 250 patients have been analyzed. Seven USER groups (0 to 6) and Four USER Categories (Never, Past/Occasional, Moderate, Heavy) were defined by the full PCUS. Factor analysis identified 4 Factors: Frequency of use, Concentrate Use, Pattern of Use and Duration of use. There was a noticeable difference between the Questions with respect to the USER group distribution. USER Group analysis for Full to Q12 & Q8 was a 10 & 14% error respectively, and for USER Categories Full to Q12 & Q8 a 7 & 5% error respectively.
Conclusions: It appears that both the PCUS-8 and the PCUS-12 result in a small error when they are compared to the Full PCUS questionnaire. The error appears higher for the 7 USER groups but is much lower for the more clinically useful USER Categories. When we have completed the planned 300 recruitment, a final Factor analysis and Q8 & Q12 Groups/Category limits will be recalculated. This will be followed by a prospective comparative evaluation. A short 2 minute Q8 assessment will be a useful pre-sedation assessment tool for those performing adolescent and young adult sedation.
