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The model includes CASM co-occurrence patterns, mutual reinforcement across CASM conditions, and reduced engagement in other preventative care due to CASM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Veterans Aging Cohort Study (VACS), a large longitudinal cohort of in-care US veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>(1) Screening alcohol, tobacco, and\/or depression symptoms; (2) adding further screening of CASM conditions likely to co-occur with those screened positive, with variation in the minimum co-occurrence rate; (3) screening all CASM conditions (hypothetical maximum).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Measures<\/jats:title>\n                    <jats:p>Estimated life expectancy (LE) and quality-adjusted life-years (QALYs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>The maximum strategy added 0.52\u00a0years to estimated LE (95% CI: 0.51 \u2013 0.54) and 0.68 QALYs\/person (95% CI: 0.67 \u2013 0.69). Screening individual CASM conditions added a small fraction of this benefit, the largest LE gain from tobacco screening: 0.08\u00a0years (95% CI: 0.07 \u2013 0.09). Screening for depression, alcohol, and tobacco provided 34.6% of the maximum strategy\u2019s LE gain (0.19\u00a0years, 95% CI: 0.17 \u2013 0.20). Additionally screening conditions with moderate (\u2265\u200920%) probability of co-occurring with those already screened positive provided 84.8% of the maximum strategy\u2019s LE gain. Screening all CASM conditions if depression, alcohol, and\/or tobacco screened positive provided 86.6% of the maximum strategy\u2019s LE gain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared to common practice of screening one or few CASM conditions, large health benefits are possible by further assessing CASM conditions most likely to co-occur with those already screening positive, improving health without increasing up-front screening burden in populations with high CASM prevalence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-026-10236-6","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T17:37:59Z","timestamp":1772041079000},"page":"2456-2464","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health Benefits of Screening for Co-occurring Alcohol-, Substance-, and Mood-related Conditions for At-Risk Populations: A Mathematical Modeling Study"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-7093","authenticated-orcid":false,"given":"Anna","family":"Bershteyn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinlian","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dyanna","family":"Charles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mellesia","family":"Jeetoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria R.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy C.","family":"Justice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie E.","family":"Chichetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon D. 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It has been granted a waiver of informed consent and is compliant with the Health Insurance Portability and Accountability Act.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"AB reports grant funding from NIH, Foundation for Innovative New Diagnostics, Gates Foundation, and World Health Organization, and consulting fees from Gates Ventures and for editorial service for PLoS Medicine. BDLM reports institution grant funding from NIH-NIDA, Vital Strategies, and Open Society Foundations, and a leadership role on the Rhode Island Opioid Settlement Advisory Committee. SC reports institution grant funding from NIH-NIDA. AJC reports institution grant funding from NIH and the Department of Veterans Affairs, payment for an UpToDate chapter, DSMB participation for NIH-NIDA grants, non-remunerated leadership roles in AMERSA, ISAJE, and ASAM, and an editor role in the journal, Substance Use & Addiction. Other authors have no conflicts of interest to report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}