What is the purpose of Substance Tolerance Assessment and Rating (STAR) screening?

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Last updated: March 12, 2025View editorial policy

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From the Guidelines

The purpose of Substance Tolerance Assessment and Rating (STAR) screening is not explicitly mentioned in the provided evidence, however, based on the context of substance misuse and screening tools, I recommend using brief validated screening tools, such as STAR, to rapidly and efficiently identify problematic drug use, including prescription medication misuse, in primary care settings. The evidence suggests that substance misuse is common among patients in primary care settings, with 22.5 million persons older than 12 years meeting criteria for substance abuse or dependence 1.

  • Brief validated screening tools, such as STAR, can help identify patients with substance use disorders, allowing for early intervention and treatment.
  • The screening process should be followed by a brief assessment to stratify patients into three categories: hazardous use, substance abuse, or substance dependence, as outlined in the study published in the American Family Physician journal 1.
  • Patients with hazardous use can benefit from brief counseling by a physician, while those with substance abuse or dependence may require more intensive ongoing follow-up, reevaluation, and potentially pharmacotherapy or referral to specialty treatment 1.
  • It is essential to use a motivational rather than a confrontational communication style during screening, counseling, and treatment to improve patient outcomes, as emphasized in the study 1.

From the Research

Substance Tolerance Assessment and Rating (STAR) Screening

There are no research papers to assist in answering this question, as none of the provided studies mention the Substance Tolerance Assessment and Rating (STAR) screening.

Available Screening Tools and Studies

Some studies discuss the importance and challenges of screening tools in general, such as:

  • The use of cost-effectiveness analyses to assess the value of screening tools 2
  • The challenges and opportunities of cost-effectiveness analysis in screening tools 2
  • The importance of informed choice in cancer screening 3
  • The call for evidence on screening for atrial fibrillation 4
  • Barriers and facilitators to participation in health screening 5

Key Points

  • Screening is an essential part of preventive medicine, and cost-effectiveness analyses can be used to assess the value of screening tools 2
  • Informed choice is important in cancer screening, and tools for practitioners and consumers should facilitate a balanced approach 3
  • There is a need for evidence on screening for atrial fibrillation, and international taskforces currently recommend against screening due to cost implications and uncertainty over benefits 4
  • Barriers and facilitators to participation in health screening have been identified, including individual, social, healthcare professional, health system, and screening procedure factors 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Cancer screening - pros, cons, choice, and the patient.

Australian family physician, 2009

Research

Barriers and Facilitators to Participation in Health Screening: an Umbrella Review Across Conditions.

Prevention science : the official journal of the Society for Prevention Research, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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