头部震颤筛查问题的有效性：四项特发性震颤病例样本分析
Validity of a screening question for head tremor: an analysis of four essential tremor case samples.
作者信息
Louis Elan D, Michalec Monika
机构信息
GH Sergievsky Center, New York, N.Y., USA.
出版信息
Neuroepidemiology. 2014;43(1):65-70. doi: 10.1159/000365991. Epub 2014 Oct 16.
BACKGROUND
The goal of this study was to assess the validity of a screening question for head tremor in essential tremor (ET). There are no published data on this topic, and the knowledge will guide future epidemiological investigations of this disorder.
METHODS
These analyses utilized four distinct patient samples: a population-based study in northern Manhattan, a study of the environmental epidemiology of ET, a genetics study, and a brain repository. Sensitivity was the proportion of ET cases with head tremor on examination who self-reported head tremor.
RESULTS
The sensitivity of the screening question for head tremor was lowest in the population-based study (31.6%), and higher as well as somewhat similar across the remaining studies (46.7 to 62.2%). Higher sensitivity was associated with tremor of longer duration, presence of voice tremor on examination, female gender, and lower education. The use of the screening question would have increased case ascertainment during the screening phase of these four studies by 1.9, 4.1, 10.2, and 20.3%.
CONCLUSIONS
A screening question for head tremor had low-to-moderate sensitivity in ET. The use of such a screening questionnaire, however, has the potential to increase case ascertainment by as much as 20% in some screening settings.
背景
本研究的目的是评估一项用于筛查特发性震颤（ET）头部震颤的问题的有效性。关于该主题尚无已发表的数据，而这一知识将指导未来对该疾病的流行病学调查。
方法
这些分析使用了四个不同的患者样本：曼哈顿北部的一项基于人群的研究、一项ET环境流行病学研究、一项遗传学研究以及一个脑库。敏感性是指在检查中出现头部震颤且自我报告有头部震颤的ET病例的比例。
结果
在基于人群的研究中，用于筛查头部震颤的问题的敏感性最低（31.6%），在其余研究中则较高且有些相似（46.7%至62.2%）。较高的敏感性与震颤持续时间较长、检查时存在声音震颤、女性性别以及较低的受教育程度相关。在这四项研究的筛查阶段，使用该筛查问题将使病例确诊率分别提高1.9%、4.1%、10.2%和20.3%。
结论
用于筛查ET头部震颤的问题敏感性低至中等。然而，在某些筛查环境中，使用这样的筛查问卷有可能使病例确诊率提高多达20%。
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