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2017 MRB Statistical Inference Report 2017 NATIONAL SURVEY ON DRUG USE AND HEALTH METHODOLOGICAL RESOURCE BOOK SECTION 13: STATISTICAL INFERENCE REPORT Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality Rockville, Maryland March 2019 This page intentionally left blank 2017 NATIONAL SURVEY ON DRUG USE AND HEALTH: METHODOLOGICAL RESOURCE BOOK SECTION 13: STATISTICAL INFERENCE REPORT For questions about this report, available at https://www.samhsa.gov/data/, please e-mail [email protected]. Prepared for Substance Abuse and Mental Health Services Administration, Rockville, Maryland Prepared by RTI International, Research Triangle Park, North Carolina March 2019 Recommended Citation: Center for Behavioral Health Statistics and Quality. (2019). 2017 National Survey on Drug Use and Health Methodological Resource Book, Section 13, Statistical Inference Report. Rockville, MD: Substance Abuse and Mental Health Services Administration. This page intentionally left blank ii Table of Contents Chapter Page 1. Introduction ......................................................................................................................... 1 2. Background ......................................................................................................................... 3 2.1 Sample Design ........................................................................................................ 3 2.2 Changes to Questionnaire Content and Survey Methodology ................................ 6 2.2.1 2016 Questionnaire Changes ...................................................................... 6 2.2.2 2017 Questionnaire Changes ...................................................................... 7 3. Prevalence Estimates .......................................................................................................... 9 3.1 Adult Major Depressive Episode .......................................................................... 10 3.2 Serious Psychological Distress ............................................................................. 10 3.3 Mental Illness ........................................................................................................ 11 3.4 Substance Use Disorders....................................................................................... 17 3.5 Substance Use Treatment ...................................................................................... 17 3.6 Perceptions of Risk and Availability .................................................................... 18 3.7 Prescription Drug Subtypes .................................................................................. 19 3.8 Adult Mental Health Outpatient Treatment .......................................................... 19 3.9 Youth Reason for Receiving Mental Health Services .......................................... 20 3.10 Decennial Census Effects on NSDUH Substance Use and Mental Health Estimates ............................................................................................................... 20 3.11 Using Revised Estimates for 2006 to 2010 ........................................................... 21 4. Missingness ....................................................................................................................... 23 4.1 Potential Estimation Bias Due to Missingness ..................................................... 23 4.2 Variance Estimation in the Presence of Missingness ........................................... 26 5. Sampling Error .................................................................................................................. 27 6. Degrees of Freedom .......................................................................................................... 33 6.1 Background ........................................................................................................... 33 6.2 Degrees of Freedom Used in Key NSDUH Analyses .......................................... 36 7. Statistical Significance of Differences .............................................................................. 39 7.1 Impact of 2014 Sample Redesign on Significance Testing between Years .......... 39 7.2 Impact of 2016 Questionnaire Changes on Significance Testing between Years ..................................................................................................................... 40 7.3 Impact of 2017 Data Quality Improvements on Significance Testing between Years ....................................................................................................... 40 7.4 Comparing Prevalence Estimates between Years ................................................. 41 7.5 Example of Comparing Prevalence Estimates between Years ............................. 42 7.6 Example of Comparing Prevalence Estimates between Years in Excel ............... 43 7.7 Comparing Prevalence Estimates in Categorical Subgroups ................................ 45 7.8 Comparing Prevalence Estimates to Identify Linear Trends ................................ 45 7.9 Impact of Rounding in Interpreting Testing Results............................................. 46 8. Confidence Intervals ......................................................................................................... 49 8.1 Example of Calculating Confidence Intervals Using Published Prevalence Estimates and Standard Errors .............................................................................. 50 iii Table of Contents (continued) Chapter Page 8.2 Example of Calculating Confidence Intervals in Excel Using Published Prevalence Estimates and Standard Errors ........................................................... 52 8.3 Example of Calculating Standard Errors Using Published Confidence Intervals................................................................................................................. 52 8.4 Example of Calculating Standard Errors in Excel Using Published Confidence Intervals ............................................................................................. 54 9. Initiation Estimates ........................................................................................................... 57 9.1 Initiation of Misuse of Prescription Psychotherapeutic Drugs ............................. 58 9.2 Initiation of Use of Substances Other Than Prescription Psychotherapeutic Drugs ..................................................................................................................... 59 10. Suppression of Estimates with Low Precision .................................................................. 63 References ..................................................................................................................................... 67 List of Contributors ....................................................................................................................... 73 Appendix A Documentation for Conducting Various Statistical Procedures: SAS®, SUDAAN®, and Stata® Examples ......................................................................................................... 75 iv List of Tables Table Page 3.1 Final SMI Prediction Models in the 2008–2012 MHSS ................................................... 14 3.2 Cut Point Probabilities for SMI, AMI, and SMMI, by 2012 Model ................................. 14 5.1 Demographic and Geographic Domains Shown in the First Findings Reports and Detailed Tables That Use the Alternative Standard Error Estimation Method for Calculating Estimated Number of Persons (Totals), 2017 .......................................... 30 6.1 Ninety-Five Percent Confidence Intervals for the Percentage of Past Month Users of Alcohol, Using Different Degrees of Freedom, 2015 .................................................. 34 6.2 Degrees of Freedom for Specific States per the NSDUH Sample Design Based on the Restricted-Use Dataset ................................................................................................ 35 6.3 Key NSDUH Analyses and Degrees of Freedom for the Restricted-Use Data File and the Public Use Data File, by Sample Design Years, 2002–2017 ............................... 37 10.1 Summary of 2017 NSDUH Suppression Rules ................................................................ 65 A.1 Summary of SUDAAN, Stata, and SAS Exhibits............................................................. 75 A.2 SUDAAN Matrix Shell ..................................................................................................... 93 A.3 Stata Matrix Shell ............................................................................................................. 94 A.4 Contrast Statements for Exhibits A.34 and A.35 ............................................................ 107 v This page intentionally left blank vi List of Exhibits Exhibit Page A.1 SUDAAN DESCRIPT Procedure (Estimate Generation: Single Year and Pooled Years of Data) 79 A.2 Stata COMMANDS svy: mean and svy: total (Estimate Generation: Single Year and Pooled Years of Data) 80 A.3 SAS SURVEYMEANS Procedure (Estimate Generation: Single Year and Pooled Years of Data) 82 A.4 SAS Code Based on SUDAAN Output (Calculation of Standard Error of Totals for Fixed Domains) 83 A.5 Stata Code (Calculation of Standard Error of Totals for Fixed Domains) 83 A.6 SAS Code Based on SAS Output (Calculation of Standard Error of Totals for Fixed Domains) 83 A.7 SAS Code Based on SUDAAN Output (Implementation of Suppression
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