中国大型流行病学研究中COPD筛查问卷的开发和验证

IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM COPD: Journal of Chronic Obstructive Pulmonary Disease Pub Date : 2022-04-06 DOI:10.1080/15412555.2022.2042504
Dingyi Wang, Guohui Fan, Sinan Wu, Ting Yang, Jianying Xu, Lan Yang, Jianping Zhao, Xiangyan Zhang, Chunxue Bai, Jian Kang, P. Ran, Huahao Shen, Fuqiang Wen, Kewu Huang, Yahong Chen, Tie-ying Sun, G. Shan, Yingxiang Lin, Guodong Xu, Rui-ying Wang, Zhihong Shi, Yong-jian Xu, Xianwei Ye, Yuanlin Song, Qiuyue Wang, Yumin Zhou, Wen Li, Liren Ding, C. Wan, W. Yao, Yanfei Guo, F. Xiao, Yong Lu, Xiaoxia Peng, Biao Zhang, D. Xiao, Zuomin Wang, X. Bu, Hong Zhang, Xiaolei Zhang, Li An, Shu Zhang, Jianguo Zhu, Zhixin Cao, Q. Zhan, Yuanhua Yang, L. Liang, H. Dai, Bin Cao, Jiang He, Chen Wang
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Ten variables were significantly associated with COPD independently in development set after a stepwise selection by multivariable logistic model and used to develop scoring system. The scoring system yielded good discrimination, as measured by AUC of 0.7737, and in the validation set, the AUC was 0.7711. When applying a cutoff point of ≥16, the sensitivity in development set was 0.69 (0.67 − 0.71); specificity 0.72 (0.71 − 0.73), PPV 0.25 (0.24 − 0.26) and NPV 0.94 (0.94 − 0.95). Conclusion We developed and validated a comprehensive screening questionnaire, COPD-CPHS, with good discrimination. The score system still needs to be validated by large cohort in the future. 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引用次数: 0

摘要

摘要目的为初级卫生保健机构建立一份易于使用的COPD危险因素和疑似症状筛查问卷。方法基于2012 - 2015年中国大陆成年人肺健康的全国流行病学研究(China pulmonary health, CPH study),招募≥40岁且完成问卷调查和肺活量测定的参与者,按2:1的比例随机分为发展组和验证组。初步选取性别、年龄、BMI、居住地、受教育程度、吸烟状况、吸烟包年、生物量暴露、父母呼吸道疾病史、每日呼吸道症状等参数制定评分系统。计算受试者工作特征(ROC)曲线、曲线下面积(AUC)、阳性预测值和阴性预测值。结果按2:1的比例随机划分,开发组22443人,验证组11221人。采用多变量logistic模型逐步筛选后,10个变量在发展组独立与COPD显著相关,并建立评分系统。评分系统产生了良好的判别,AUC为0.7737,在验证集中,AUC为0.7711。当截断点≥16时,发育组的敏感性为0.69 (0.67 ~ 0.71);PPV特异性0.72(0.71−0.73),0.25(0.24−0.26)和净现值为0.94(0.94−0.95)。结论我们编制并验证了COPD-CPHS综合筛查问卷,具有良好的甄别性。分数系统仍需要在未来进行大规模的队列验证。本文的补充数据可在https://doi.org/10.1080/15412555.2022.2042504上在线获得。
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Development and Validation of a Screening Questionnaire of COPD from a Large Epidemiological Study in China
Abstract Objective We aimed to establish an easy-to-use screening questionnaire with risk factors and suspected symptoms of COPD for primary health care settings. Methods Based on a nationwide epidemiological study of pulmonary health among adults in mainland China (China Pulmonary Health, CPH study) between 2012 and 2015, participants ≥40 years who completed the questionnaire and spirometry tests were recruited and randomly divided into development set and validation set by the ratio of 2:1. Parameters including sex, age, BMI, residence, education, smoking status, smoking pack-years, biomass exposure, parental history of respiratory diseases and daily respiratory symptoms were initially selected for the development of scoring system. Receiver operating characteristic (ROC) curve, area under curve (AUC), positive and negative predictive values were calculated in development set and validation set. Results After random split by 2:1 ratio, 22443 individuals were assigned to development set and 11221 to validation set. Ten variables were significantly associated with COPD independently in development set after a stepwise selection by multivariable logistic model and used to develop scoring system. The scoring system yielded good discrimination, as measured by AUC of 0.7737, and in the validation set, the AUC was 0.7711. When applying a cutoff point of ≥16, the sensitivity in development set was 0.69 (0.67 − 0.71); specificity 0.72 (0.71 − 0.73), PPV 0.25 (0.24 − 0.26) and NPV 0.94 (0.94 − 0.95). Conclusion We developed and validated a comprehensive screening questionnaire, COPD-CPHS, with good discrimination. The score system still needs to be validated by large cohort in the future. Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2022.2042504 .
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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
38
审稿时长
6-12 weeks
期刊介绍: From pathophysiology and cell biology to pharmacology and psychosocial impact, COPD: Journal Of Chronic Obstructive Pulmonary Disease publishes a wide range of original research, reviews, case studies, and conference proceedings to promote advances in the pathophysiology, diagnosis, management, and control of lung and airway disease and inflammation - providing a unique forum for the discussion, design, and evaluation of more efficient and effective strategies in patient care.
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