无监督的家庭螺旋测量与对照的监督诊所螺旋测量呼吸系统疾病:一个系统的方法审查和元分析
Rohan Anand1, Rebecca McLeese1, John Busby2
1Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.
概括
无监督家庭螺旋计与监督测试是不可互换的. 这次系统性审查发现,无监督测试产生较低的肺功能值,具有显著的可变性,质疑其临床用途.
科学领域:
- 肺部医学 肺部医学
- 诊断的准确性 诊断的准确性
- 医疗技术 医疗技术 医学技术
背景情况:
- 由于便携式技术和COVID-19大流行,越来越多地使用无监督的家庭螺旋计.
- 缺乏强有力的证据支持无监督家庭螺旋计的可靠性.
- 这项研究解决了无监督和监督螺旋计之间的定量比较的需要.
研究的目的:
- 量化比较无监督家庭螺旋计和监督诊所螺旋计之间的测量差异.
- 评估无监督螺旋计结果与监督结果的可互换性.
- 评估无监督螺旋计对常见肺功能参数的可靠性.
主要方法:
- 系统的方法审查和28项研究的元分析.
- 使用布兰德-阿尔特曼分析对1秒内强迫呼气体积 (FEV1) 和强迫生命能力 (FVC) 的定量比较.
- 评估异质性 (I2),偏差风险 (QUADAS-2) 和证据确定性 (GRADE).
主要成果:
- 与监督螺旋计相比,无监督螺旋计产生较低的FEV1 (平均差异-107毫升) 和FVC (平均差异-184毫升).
- 在无监督测量中观察到显著的变异性,FEV1和FVC的一致性极大.
- 高异质性 (I2>95%) 和非常低的证据确定性.
结论:
- 无监督的家庭螺旋计不能与监督的螺旋计互换,用于个体患者的评估.
- 无监督螺旋计的变化和低估限制了其临床适用性.
- 需要进一步的研究来确定无监督螺旋计在临床实践中的有效性和可靠性.
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