Evidence map›Paper›PMID 38421358›Full record

ArticleClinical toxicology (Philadelphia, Pa.)2024

Accuracy and replicability of identifying eyelid tremor as an indicator of recent cannabis smoking.

George Sam Wang, Michael Kosnett, Prem Subramanian, Julia Wrobel, Ming Ma, Tim Brown, L Cinnamon Bidwell, Ashley Brooks-Russell

Open access · greenAbstract read
In one paragraph

Article in Clinical toxicology (Philadelphia, Pa.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Pupillary dynamics as a marker of acute cannabis inhalation.Clinical toxicology (Philadelphia, Pa.) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

George Sam WangUniversity of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO, USA.
Michael KosnettUniversity of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Prem SubramanianDepartments of Ophthalmology, Neurology, and Neurosurgery, Sue Anschutz-Rodgers University of Colorado Eye Center, Aurora, CO, USA.
Julia WrobelDepartment of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA.
Ming MaDepartment of Biostatistics, Medpace, Denver, CO, USA.
Tim BrownDriving Safety Research Institute, College of Engineering, University of Iowa, Iowa City, Iowa, USA.
L Cinnamon BidwellInstitute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA.
Ashley Brooks-RussellInjury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
University of Colorado Anschutz Medical Campus · USEmory University · USMedpace (United States) · USUniversity of Colorado Boulder · USUniversity of Iowa · US

Funding

Novel approaches to assessing cannabis impaired drivingR01DA049800 · NIDA · UNIVERSITY OF COLORADO DENVER · PI BROOKS-RUSSELL, ASHLEY · 2020 to 2024
$2.6M
NIDA NIH HHS R01 DA049800
6 · The paper itself

Abstract

introductionCannabis intoxication may increase the risk of motor vehicle crashes. However, reliable methods of assessing cannabis intoxication are limited. The presence of eyelid tremors is among the signs of cannabis use identified under the Drug Evaluation and Classification Program of the International Association of Chiefs of Police. Our objectives were to assess the accuracy and replicability of identifying eyelid tremor as an indicator of recent cannabis smoking using a blinded, controlled study design.

methodsAdult subjects (

resultsKappa and intraclass correlation coefficient statistics demonstrated moderate agreement among the coders, which ranged from 0.44-0.45 and 0.58-0.61, respectively. There was no significant association between recent cannabis use and the observers' consensus assessment that eyelid tremor was present, and cannabis users were less likely to have tremors (odds ratio: 0.75; 95 percent confidence interval: 0.25, 2.40). The assessment of eyelid tremor as an indicator of recent cannabis smoking had a sensitivity of 0.86, specificity of 0.18, and accuracy of 0.64. DISCUSSION: Eyelid tremor has fair sensitivity but poor specificity and accuracy for identification of recent cannabis use. Inter-rater reliability for assessment of eyelid tremor was moderate for the presence and degree of tremor. The weak association between recent cannabis use and eyelid tremor does not support its utility in identifying recent cannabis use. LIMITATIONS: Videos were recorded at only one time point after cannabis use. Adherence to abstinence could not be strictly supervised. Due to regulatory restrictions, we were unable to control the cannabis product used or administer a fixed Δ

conclusionsIn a cohort of participants with a range of cannabis use histories, acute cannabis smoking was not associated with the presence of eyelid tremor, regardless of cannabis use history, at 70 minutes post-smoking. Additional research is needed to identify the presence of eyelid tremor accurately, determine the relationship between cannabis dose and timeline in relation to last cannabis use to eyelid tremor, and determine how it should be, if at all, utilized for cannabis Drug Recognition Evaluator examinations.

Indexed as

EyelidsHallucinogensMarijuana AbuseSubstance Abuse DetectionAdultCannabisHumansMarijuana SmokingReproducibility of ResultsTremorHallucinogensCannabisdrug recognition experteyelid tremorimpairmentmarijuana

Identifiers

PMID38421358
PMCPMC11019859
OpenAlexW4392305173

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.