尹欣,吴毅凌,侯珊珊,等.不同筛查问卷对上海市松江社区居民慢性阻塞性肺疾病筛查效果的评价[J].上海预防医学,2024,36(4):386-392.. doi: 10.19428/j.cnki.sjpm.2024.23472
引用本文: 尹欣,吴毅凌,侯珊珊,等.不同筛查问卷对上海市松江社区居民慢性阻塞性肺疾病筛查效果的评价[J].上海预防医学,2024,36(4):386-392.. doi: 10.19428/j.cnki.sjpm.2024.23472
YIN Xin,WU Yiling,HOU Shanshan,et al.Efficacy of different questionnaires in screening COPD in the communities of Songjiang District, Shanghai[J].Shanghai Journal of Preventive Medicine,2024,36(04):386-392.. doi: 10.19428/j.cnki.sjpm.2024.23472
Citation: YIN Xin,WU Yiling,HOU Shanshan,et al.Efficacy of different questionnaires in screening COPD in the communities of Songjiang District, Shanghai[J].Shanghai Journal of Preventive Medicine,2024,36(04):386-392.. doi: 10.19428/j.cnki.sjpm.2024.23472

不同筛查问卷对上海市松江社区居民慢性阻塞性肺疾病筛查效果的评价

Efficacy of different questionnaires in screening COPD in the communities of Songjiang District, Shanghai

  • 摘要:
    目的 评估3种慢性阻塞性肺疾病(COPD)筛查问卷在上海市松江社区居民中的筛查效果,对不同性别的筛查效果进行比较,为选择筛查问卷和方案提供依据。
    方法 基于松江自然人群队列,随机抽取3 184名≥40岁社区居民进行COPD问卷筛查和肺功能检查,筛查问卷包括COPD筛查问卷(COPD⁃SQ)、COPD人群筛查问卷(COPD⁃PS)和改良COPD诊断问卷(改良CDQ)。基于受试者工作特征曲线下面积(AUC)对筛查效果进行评价。分别使用DeLong法和Z检验,比较不同筛查问卷和同一筛查问卷不同截断值时的筛查准确性。
    结果 3 184名居民中肺功能检查共筛查出259名(8.1%)COPD患者。推荐截断值时3种问卷的灵敏度和特异度分别为COPD⁃SQ(63.7%和72.2%),COPD⁃PS(12.0%和96.1%),改良CDQ(78.8%和52.7%);COPD⁃SQ的筛查准确性最高(AUC=0.754)。3种问卷在该人群中的最佳截断值和推荐截断值不同,但仅在COPD⁃PS中准确性差异有统计学意义。3种问卷男性和女性的最佳截断值不同,且当对女性取更低的截断值时COPD⁃SQ和COPD⁃PS的筛查灵敏度和准确性提高。两两并联使用问卷进行筛查时,AUC较单独使用高,但差异无统计学意义。
    结论 推荐使用COPD⁃SQ问卷进行初筛;应当考虑对女性设置更低的截断值。COPD筛查问卷仍需要进一步改进,以便于COPD患者的早期识别和治疗。

     

    Abstract:
    Objective To evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District, Shanghai, and to provide a basis for selecting COPD screening questionnaire and process that are more suitable.
    Methods Community residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire (COPD-SQ), the COPD population screener (COPD-PS) and the revised COPD diagnostic questionnaire (revised-CDQ). Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve (AUC) of the subjects. DeLong test was used to compare the accuracy of different questionnaires; Z test was used to compare the accuracy of different cut-off values for the same questionnaire.
    Results Among 3 184 community residents, a total of 259 (8.1%) COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ (63.7% and 72.2%), COPD-PS (12.0% and 96.1%), and revised CDQ (78.8% and 52.7%), with the COPD-SQ having the highest screening accuracy (AUC=0.754). The optimal and recommended cut-off values for the three questionnaires differed in this population, but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female, and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening, but the differences were not statistically significant.
    Conclusion The COPD-SQ is recommended for primary COPD screening; a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.

     

/

返回文章
返回