现有的指甲牛皮严重性评分工具的诊断能力是什么?
Evi C C Rikken1, Tamara W van Hal2, Juul M P A van den Reek1
1Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
International journal of dermatology
|August 24, 2025
概括
尼姆根指甲牛皮活动指数工具 (N-NAIL) 和指甲牛皮严重程度指数 (NAPSI) 可以准确诊断指甲牛皮 (NP). 与NAPSI相比,N-NAIL在2的截止值显示出更高的诊断准确性.
科学领域:
- 皮肤病学
- 临床试验
- 诊断的准确性
背景情况:
- 区分指甲牛皮 (NP) 和非特异性指甲变化是困难的,影响临床试验的一致性.
- 目前的NP评分工具主要评估诊断后的严重程度.
- 本研究评估了两种NP严重性评分工具的诊断性能.
研究的目的:
- 评估指甲牛皮严重程度指数 (NAPSI) 和尼姆根指甲牛皮活动指数工具 (N-NAIL) 的诊断准确性.
- 确定这些工具在识别指甲牛皮时的最佳切割值.
- 确定这些工具在临床试验患者选择中的有用性.
主要方法:
- 一项队列研究将牛皮患者与匹配的对照人群进行比较.
- 使用NAPSI和N-NAIL进行指甲评分.
- 根据Youden指数和临床推理,使用接收器操作特征 (ROC) 曲线来确定灵敏度,特异性和最佳切断值.
主要成果:
- N-NAIL的最佳精度为2 (在牛皮患者中敏感度为83. 8%,特异性为83. 3%).
- 在牛皮患者群体中,NAPSI的精度为7 (灵敏度为80. 9%,特异性为69. 4%).
- 与NAPSI相比,N-NAIL的整体准确性更高.
结论:
- 在牛皮患者群体中,N-NAIL和NAPSI都提供了可靠的切断值.
- 这些工具可以帮助评估严重程度和为临床试验选择患者,从而提高研究的一致性.
- 由于其诊断准确度较高,建议使用N-NAIL,截止值为2.
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