在使用便携式设备,PICO-6®和COPD-6®时,在初级医疗保健服务中检测COPD时,FEV1/FEV6截止点以避免虚假阴性
Miguel A Hernandez-Mezquita1,2,3, Idania De Los Santos-Ventura1, Vanesa Hidalgo-Sierra4
1Pneumology Department, Salamanca University Hospital, 37007 Salamanca, Spain.
Journal of clinical medicine
|January 25, 2025
概括
像Piko-6®和COPD-6®这样的便携式设备可以在初级保健中查慢性阻塞性肺病 (COPD). 将FEV1/FEV6比率的截止值调整为Piko-6®的0.73和COPD-6®的0.80,可以提高准确性,避免错误诊断.
科学领域:
- 肺部医学 肺部医学
- 诊断工具 诊断工具
- 主要护理查初级护理检查
背景情况:
- 慢性阻塞性肺病 (COPD) 往往被低诊断,原因是初级保健中对螺旋计的获取有限.
- 便携式呼气流量计 (Piko-6®,COPD-6®) 为COPD查提供了一个替代方案.
- 这些设备测量FEV1和FEV6,但不是FVC,需要验证FEV1/FEV6比率.
研究的目的:
- 为了确定Piko-6®和COPD-6®设备的最佳FEV1/FEV6截止值.
- 使用这些便携式设备,尽量减少初级保健中COPD查中的假阴性.
- 为了将Piko-6®和COPD-6®的准确性与强制螺旋计 (FS) 的黄金标准进行比较.
主要方法:
- 招募了664名患者 (≥35岁,≥10包年吸烟史).
- 强制螺旋测量 (FS) 是作为黄金标准进行的.
- 来自Piko-6®和COPD-6®的测量结果与FS使用相关性,Youden指数,kappa系数,Bland-Altman图表和ROC分析进行了比较.
主要成果:
- 来自Piko-6®和COPD-6®的FEV1/FEV6与FS FEV1/FVC (0.79和0.73) 有良好的相关性.
- 最佳的尤登指数值为Piko-6®的0.73和COPD-6®的0.80.
- 与FS的一致性为Piko-6®的83.9% (卡帕0.67) 和COPD-6®的68.7% (卡帕0.42).
结论:
- 皮科-6®和COPD-6®是COPD检测的有效工具,与FS有很好的相关性.
- 这项研究是第一个将这两种手持设备与FS进行比较的研究.
- 为了防止虚假阴性,在初级保健机构中,FEV1/FEV6的切断值应为Piko-6®的0.73和COPD-6®的0.80.
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