Gariti Peter, Rosenthal David I, Lindell Kathleen, Hansen-Flaschen John, Shrager Joseph, Lipkin Craig, Alterman Arthur I, Kaiser Lawrence R
University of Pennsylvania Cancer Center Group, Philadelphia Veterans Affairs Medical Center and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6178, USA.
Cancer Epidemiol Biomarkers Prev. 2002 Oct;11(10 Pt 1):1123-5.
This report evaluates the validity of a new method for verifying self-reported smoking status in patients presenting for pulmonary medicine treatment. A prospective comparison was made between self-reports of smoking status and a new semiquantitative, enzyme-linked, immunosorbent assay-based method testing for the presence of a prime nicotine metabolite, cotinine. Results were validated by gas chromatography/mass spectrometry. Data were collected in an urban, academic, tertiary health care setting. The study included 76 consecutive new patients presenting to participating clinical practices at the Pulmonology or Thoracic Surgery Services. Before taking a smoking history, patients were informed that their urine would be tested onsite for the presence of nicotine using a new method, the NicoMeter, for determining tobacco product exposure, followed by more standard laboratory testing. The level of agreement between the biochemical measurement types was excellent, kappa = 0.777. The new biochemical measurement type used was easy to use. Self-reported smoking status corresponded closely to biochemical testing. However, there was a 5.3-9.5% misclassification of smoking status among the group studied, depending upon the measurement type used. Among 32 lung cancer patients, 15.6%, most likely misrepresented their current smoking status. The NicoMeter appears to be a valid and useful method for confirming self-reported smoking status. Lung cancer patients had a higher rate of inaccurate nonsmoking compared with patients with nonmalignant pulmonary disease. The findings have implications for investigators who accept self-reported smoking status without biochemical verification.
本报告评估了一种用于核实前来接受肺病治疗患者自我报告吸烟状况的新方法的有效性。对吸烟状况的自我报告与一种新的基于酶联免疫吸附测定的半定量方法进行了前瞻性比较，该方法用于检测主要尼古丁代谢物可替宁的存在。结果通过气相色谱/质谱法进行了验证。数据在一家城市学术三级医疗保健机构收集。该研究纳入了76名连续就诊于肺科或胸外科参与临床实践的新患者。在获取吸烟史之前，告知患者其尿液将在现场使用一种新方法（NicoMeter）检测尼古丁的存在，以确定烟草制品暴露情况，随后进行更标准的实验室检测。两种生化测量类型之间的一致性水平极佳，kappa值 = 0.777。所使用的新生化测量类型易于操作。自我报告的吸烟状况与生化检测结果密切相关。然而，在所研究的人群中，根据所使用的测量类型，吸烟状况的错误分类率为5.3% - 9.5%。在32名肺癌患者中，15.6%的人很可能误报了他们当前的吸烟状况。NicoMeter似乎是一种有效且有用的方法，用于确认自我报告的吸烟状况。与非恶性肺病患者相比，肺癌患者不准确地报告不吸烟的比例更高。这些发现对那些接受未经生化验证的自我报告吸烟状况的研究者具有启示意义。
