SRS-22r question 11 is a valid opioid screen and stratifies opioid consumption

Purpose To validate the Scoliosis Research Society-22r (SRS-22r) question 11 (Q11) response as a measure to assess and quantify opioid consumption. Methods A post hoc analysis of a prospective study regarding opioid use during ASD surgery was performed. Data were collected at enrollment and 2-year follow-up including the SRS-22r and a standardized data collection form (CRF) for self-reported opioid consumption. Responses to Q11 of the SS-22r were compared with responses to the opioid consumption CRF (as measured by morphine equivalent dose (MED)). Inter-rater agreement was calculated. Sensitivity and specificity for the Q11 (+) responses were calculated using MED reports as the “true” value. Results Cohen’s kappa indicated almost perfect agreement between the MED CRF and Q11 ( k = 0.878, p < 0.001). Mean daily MED consumption for patients reporting “Daily Narcotic” use was 62.0 (Median: 38.7, SD 87.5) mg; for patients reporting “Narcotics weekly or less”, mean daily MED consumption was 21.6 (15.0, 29.0) mg. The positive Q11 responses were 96% sensitive and 92% specific for opioid users. Conclusion SRS-22r Q11 exhibits almost perfect agreement with an independent questionnaire designed to assess opioid consumption in this cohort. “Daily narcotic” users report nearly three times the mean daily MED of “Weekly or less” users (62.0 ± 87.5 mg vs 21.6 ± 29 mg, p = 0.037). Q11 exhibited excellent sensitivity and specificity for determining opioid users and non-users. Given the need for opioid research in ASD, Q11 may be useful to use existing registries and observational cohorts to design more definitive studies regarding opioid consumption. Level of evidence III.