结合FEV1/FEV6和COPD诊断问卷的两阶段风险分层策略作为一种准确且具有成本效益的COPD病例发现方法
Po-Chun Lo1, Hsin-Kuo Ko2,3, Kun-Ta Chou2,3,4
1Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan, ROC.
概括
将COPD诊断问卷 (CDQ) 与FEV1/FEV6测量相结合,为鉴定COPD提供了最高的诊断准确性. 使用这些工具的两阶段策略可以准确且具有成本效益地检测未被诊断的COPD病例.
科学领域:
- 肺部医学 肺部医学
- 诊断准确性研究 诊断准确性研究
- 呼吸系统健康 呼吸系统健康
背景情况:
- 基于症状的问卷和手持式肺功能设备用于COPD病例的发现.
- 诊断准确性的最佳组合仍然不清楚.
研究的目的:
- 为了比较手持肺功能设备和COPD问卷的各种组合的诊断准确性.
- 制定一个有效的COPD病例发现策略.
主要方法:
- 这是一项横截面,前性,观察性研究,对224名年龄≥40岁的参与者进行了呼吸系统症状和≥10个吸烟包年.
- 使用了三个问卷 (CDQ,肺功能问卷,COPD人口查) 和两个手持设备 (峰值流量计,微螺度计).
- 使用接收器操作特征曲线下的面积 (AUROC) 评估的诊断准确性,以螺旋计为黄金标准.
主要成果:
- FEV1/FEV6测量表明诊断准确度高于单独使用问卷.
- 使用FEV1/FEV6的组合表现优于使用峰值呼气流速 (PEFR) 的组合.
- CDQ和FEV1/FEV6的组合实现了最高的诊断准确性 (AUROC 0.903),FEV1/FEV6<0.76.7的最佳切线.
结论:
- FEV1/FEV6和CDQ的组合显示了COPD检测的卓越诊断准确性.
- 建议使用CDQ和FEV1/FEV6的两阶段风险分层策略是准确且具有成本效益的,用于识别有风险的未被诊断的COPD.
- 需要对拟议的战略进行外部验证.
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