Raciborski Filip, Samoliński Bolesław, Krzych-Fałta Edyta, Grąbczewska Aleksandra, Furman Filip, Bieszczad Michał, Morkisz Paweł, Witkowska Patrycja, Bousquet Jean, Gujski Mariusz
Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
The Healthcare Institute, Warsaw, Poland.
J Thorac Dis. 2018 Sep;10(9):5595-5604. doi: 10.21037/jtd.2018.08.97.
In 2006, the Global Alliance against Chronic Respiratory Diseases (GARD) was established. The GARD strategy is based mainly on activities aimed at implementing preventive tasks at a local and global level. In Poland, the National Health Program (NHP) is the strategic document describing the tasks of governmental and local administration in the field of public health. One of the activities under the NHP is a project to carry out mass allergy screening (of children and adolescents at school age) and to organize an information and education campaign.
In 2017-2018, the screening will cover a group of at least 10,000 children and adolescents at school age (6-18 years of age) in 10 of 16 voivodships in Poland. In the study, the e-health tool for early pre-medical risk assessment of allergic diseases was used. The algorithm determines the risk of bronchial asthma (BA) and allergic rhinitis (AR) based on a series of 38 questions on the symptoms of allergic diseases. In order to assess the effectiveness of the screening test (algorithm) a validation study was carried out before screening. Moreover, the algorithm was calibrated on the basis of the obtained results. The screening is accompanied by a nationwide information and education campaign carried out by means of new media.
A total of 1,008 children and adolescents participated in the validation study. In outpatient examination AR was diagnosed in 46.4% and BA in 11.2%. In the case of AR, the sensitivity of the calibrated version of the algorithm was 0.852 and the specificity was 0.840. In the case of BA, it was 0.841 and 0.912, respectively. In 2017, 1,512 people used the screening tool, of which 1,472 respondents went through all stages of the assessment. BA positive AR result (probably sick) was found in 19.5% of respondents and BA in 8.4%.
The use of e-health tools in mass screening and new media to conduct information and education campaigns allows for the reduction of costs and for efficient implementation of activities. It is important to popularize the use of this type of solutions both at national and local level.
2006年,全球抗击慢性呼吸道疾病联盟(GARD)成立。GARD战略主要基于旨在在地方和全球层面实施预防任务的活动。在波兰,国家卫生计划(NHP)是描述政府和地方行政部门在公共卫生领域任务的战略文件。NHP下的一项活动是开展大规模过敏筛查(针对学龄儿童和青少年)并组织信息和教育活动的项目。
2017 - 2018年,筛查将覆盖波兰16个省中10个省的至少10000名学龄儿童和青少年(6 - 18岁)。在该研究中,使用了用于过敏性疾病早期医学前风险评估的电子健康工具。该算法基于一系列关于过敏性疾病症状的38个问题来确定支气管哮喘(BA)和过敏性鼻炎(AR)的风险。为了评估筛查测试(算法)的有效性,在筛查前进行了验证研究。此外,根据获得的结果对算法进行了校准。筛查伴随着通过新媒体开展的全国性信息和教育活动。
共有1008名儿童和青少年参与了验证研究。在门诊检查中,诊断出AR的占46.4%,诊断出BA的占11.2%。对于AR,校准后的算法灵敏度为0.852,特异性为0.840。对于BA,分别为0.841和0.912。2017年,1512人使用了筛查工具,其中1472名受访者完成了所有评估阶段。在受访者中,19.5%的人BA呈阳性且AR结果(可能患病)呈阳性,8.4%的人BA呈阳性。
在大规模筛查中使用电子健康工具以及利用新媒体开展信息和教育活动能够降低成本并高效实施活动。在国家和地方层面推广使用这类解决方案很重要。