Study Limitations:
There are a few notable limitations to our study. First, we relied on
self-reported rather than clinical data, so the associations of
substance use with health outcomes and CFTR modulators may be under- or
over-reported. Second, the survey was administered through online
channels utilizing social media platforms, a method susceptible to
infiltration of fraudulent responses. We addressed this by including
internal validity questions and using CAPTCHA (Completely Automated
Public Turing test to tell Computers and Humans Apart) feature. We
carefully reviewed the validity questions and removed suspected
automated responses by bots from the study. Third, subjects recruited
via social media may represent pwCF who have an interest in these
substances, which would potentially overestimate the prevalence,
however, we found that the prevalence was not significantly skewed
toward current use relative to non-use. The survey was also not
translated into Spanish, limiting the participation of a subset of
potential subjects, and our findings’ generalizability; therefore, our
results should not preclude discussions around substance use in all
pwCF.