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【目的】对自行设计的儿童哮喘筛查问卷的合理性以及其信度和效度进行评价。【方法】利用试点监测研究基线调查和初次监测结果数据以及既往医疗机构诊断的儿童哮喘病例等对儿童哮喘筛查问卷的效度和信度进行评价。【结果】筛查表项目前后两次重复检测结果具有较好的一致性,Kappa>0.5,相关系数最高为0.82。以既往临床诊断为金标准,筛查表各项指标特异度都超过98.5;灵敏度相差较大,其中既往喘息症状最高为91.3%,慢性咳嗽症状最低,仅为17.4%。哮喘可疑病例项敏感度为100%,特异度为98.5%,阳性预测值为39.5%,阴性预测值为98.5%;以病例对照研究的病例作为金标准,喘息症状项的灵敏度最高,为77.3%;慢性咳嗽症状项灵敏度最低,为9.9%。特异度除夜间咳嗽项为92.1%外,其他项目都超过95%。哮喘可疑病例项的敏感度为95.6%,特异度为90.1%,阳性预测值为21.8%,阴性预测值为95.3%。【结论】儿童哮喘筛查问卷具有良好信度和效度。该问卷为基于人群的儿童哮喘监测以及流行病学研究中病例初步筛查工作提供了有效的工具。
【Objective】 To evaluate the rationality, reliability and validity of self-designed childhood asthma screening questionnaire. 【Method】 Validity and reliability of the Childhood Asthma Screening Questionnaire were evaluated by using the data from the baseline survey and primary monitoring results of the pilot monitoring study and the cases of childhood asthma diagnosed by the previous medical institutions. 【Results】 The results of two repeated tests before and after the screening item showed good agreement, with Kappa> 0.5 and the highest correlation coefficient of 0.82. With the previous clinical diagnosis as the gold standard, the specificity of each index of the screening table exceeded 98.5; the sensitivities varied greatly, with the highest previous symptom of asthma being 91.3% and the lowest rate of chronic cough being only 17.4%. Susceptible cases of asthma suspect case sensitivity was 100%, specificity was 98.5%, the positive predictive value was 39.5%, negative predictive value was 98.5%; case-control study of the case as the gold standard, the highest sensitivity of wheezy items was 77.3% The lowest sensitivity of chronic cough was 9.9%. Specificity in addition to nighttime cough was 92.1%, other projects are more than 95%. The suspicious cases of asthma had a sensitivity of 95.6%, a specificity of 90.1%, a positive predictive value of 21.8% and a negative predictive value of 95.3%. 【Conclusion】 Childhood asthma screening questionnaire has good reliability and validity. The questionnaire provides an effective tool for population-based surveillance of childhood asthma and initial screening of cases in epidemiological studies.