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对慢性阻塞性肺病的五个临床问卷的诊断性能进行比较

Alirio R Bastidas¹, Eduardo Tuta-Quintero¹, José S Arias¹

¹School of Medicine, Universidad de La Sabana, Chía, Colombia.

Canadian respiratory journal

|December 4, 2023

概括

临床问卷显示在诊断慢性阻塞性肺病 (COPD) 方面可以接受,但效果有限. 除了这些工具,还建议进行进一步的诊断测试,以准确识别COPD.

科学领域:

肺部病理学肺部病理学
诊断医学诊断医学诊断医学
流行病学流行病学

背景情况:

慢性阻塞性肺病 (COPD) 是一个广泛的全球健康问题,对死亡率和发病率作出了重大贡献.
低诊断是有效管理COPD的一个主要挑战.
正在探索临床问卷作为一种策略,以确定患有COPD高风险的个体,促使进一步的诊断评估.

研究的目的:

评估和比较COPD五个不同的临床问卷的诊断性能.
具体而言,这项研究的目的是评估COULD IT BE COPD,CDQ,COPD-PS,LFQ和PUMA问卷.

主要方法:

一项涉及681名接受螺旋测量试验的受试者的横截面研究.
数据收集发生在2015年1月至2020年3月期间.
性能指标包括AUC-ROC,灵敏度,特异性,PPV,NPV,LR+和LR-被计算为每个问卷,与AUC-ROC比较使用DeLong测试.

主要成果:

在研究人群中,COPD的患病率为27.5%.
与COPD诊断相关的因素包括男性性别,年龄较大,呼吸道症状和木烟暴露.
所有评估的问卷显示AUC-ROC在0.581和0.681之间,COULD IT BE COPD问卷显示最低的歧视能力.

结论:

在CDQ,COPD-PS,LFQ,PUMA和COULD IT BE COPD问卷表现出可接受的COPD诊断性能.
然而,这些问卷在敏感性和特异性方面存在局限性.
当它们与其他诊断方法一起使用时,例如肺功能测试时,它们的临床实用性会得到提高.

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