工作相关喘查工具及其诊断准确性:系统性审查
Ngamjit Kongsupon1,2, Peymane Adab1, Rachel E Jordan1
1Department of Applied Health Sciences, University of Birmingham, Birmingham, UK.
BMJ open respiratory research
|July 15, 2025
概括
工作相关喘 (WRA) 的查工具显示高灵敏度但低特异性. 简单的问题,如"改善工作"可以帮助早期WRA检测,但进一步的研究是需要更好的诊断准确性.
科学领域:
- 职业医学 职业医学是专业的.
- 呼吸系统医学 呼吸系统医学
- 诊断准确性研究 诊断准确性研究
背景情况:
- 与工作相关的喘 (WRA) 占成人喘病例的很大一部分.
- 延迟或错过临床诊断WRA导致不良健康和就业结果.
- 现有的WRA查工具的诊断性能需要标准化和评估.
研究的目的:
- 系统地审查和比较用于识别与工作有关的喘 (WRA) 的查工具的有效性.
- 在临床和职业环境中评估WRA查工具的性能.
主要方法:
- 在多个数据库中对1975年至2024年间发表的研究进行了全面的文献搜索.
- 包括的研究使用结构化问卷或预测模型 (有或没有生理测试) 来识别16岁及以上个体的WRA.
- 使用 QUADAS-2 或 PROBAST 评估偏差风险,并使用森林地块总结准确度指数.
主要成果:
- 包括七项研究,主要是在三级和专科医院环境中进行的.
- 单独使用问卷 ("工作之外的改进"或多个问题) 显示了WRA检测的高灵敏度 (74-100%),但低特异性 (8-58%).
- 添加甲胆挑战测试提高了特异性至75% (灵敏度为65%),诊断模型实现了0.69-0.89之间的AUC,由人口统计或客观数据增强.
结论:
- 针对WRA的查问卷具有高灵敏度,适合初始病例识别,尽管特异性低.
- 纳入人口变量和客观测试可以提高WRA查模型的特异性和预测准确性.
- 报告和研究数量有限,需要在初级保健和工作场所环境中进一步评估WRA查工具.
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