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用于夜间工作者特殊健康检查中胃肠道疾病筛查的健康筛查问卷的验证

Validation of health screening questionnaire used for screening gastrointestinal disorder in worker's special health examination for night time work.

作者信息

Lee JaeYong, Lee Ji-Won, Choi WonSeon, Myong Jun-Pyo

机构信息

Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Suwon Center, Korea Medical Institute, Suwon, Korea.

出版信息

Ann Occup Environ Med. 2019 Jun 14;31:e8. doi: 10.35371/aoem.2019.31.e8. eCollection 2019.

Abstract

BACKGROUND

Since the night time work was introduced as a 'harmful factor' for the worker's special health examination (WSHE) in 2014, the validation of the questionnaire used for screening gastrointestinal (GI) disorder has not been conducted. The purpose of this study is to verify the validity of the questionnaire using the data of specific health screening cluster.

METHODS

We used WSHE screening data for 3 years, from 2014 to 2016, in health screening cluster. The subjects who had received upper GI endoscopy in opportunistic screening and WSHE simultaneously regardless of the results of the questionnaire were selected. We tested the validity of the questionnaire using upper GI endoscopy as a gold standard.

RESULTS

This study was conducted on 5,057 examinees in 2014, 8,352 examinees in 2015, and 10,587 examinees in 2016. The validity of the questionnaire for each year was as follows: sensitivity 12.3% (95% confidence interval [CI], 11.1-13.4), specificity 88.6% (95% CI, 87.2-90.1), accuracy 41.1% (95% CI, 39.8-42.5) in 2014, sensitivity 5.9% (95% CI, 5.2-6.5), specificity 93.6% (95% CI, 92.7-94.4), accuracy 38.6% (95% CI, 37.6-39.6) in 2015, sensitivity 6.0% (95% CI, 5.4-6.5), a specificity of 9.42% (95% CI, 93.4-95.0), accuracy of 34.2% (95% CI, 33.3-35.1) in 2016. In generally, questionnaire showed sensitivity of 10%, specificity of 90%, and accuracy of 40%.

CONCLUSIONS

Despite the purpose of WSHEs aiming to identify target disease early, the sensitivity of the questionnaire for GI disease was too low as 10%. The reasons for this are the problem of the question itself, and the problem of ambiguous target disease. In the future, the questionnaire should be improved to meet the purpose of the WSHE, and further correction of the target disease should be made.

摘要

背景

自2014年夜班工作被列为劳动者特殊健康检查(WSHE)的“有害因素”以来,用于筛查胃肠道疾病问卷的有效性尚未得到验证。本研究的目的是使用特定健康筛查集群的数据来验证该问卷的有效性。

方法

我们使用了2014年至2016年3年期间健康筛查集群中的WSHE筛查数据。选择了在机会性筛查和WSHE中同时接受上消化道内镜检查的受试者,无论问卷结果如何。我们以上消化道内镜检查作为金标准来测试问卷的有效性。

结果

2014年对5057名受检者、2015年对8352名受检者、2016年对10587名受检者进行了研究。每年问卷的有效性如下:2014年灵敏度为12.3%(95%置信区间[CI],11.1 - 13.4),特异度为88.6%(95% CI,87.2 - 90.1),准确度为41.1%(95% CI,39.8 - 42.5);2015年灵敏度为5.9%(95% CI,5.2 - 6.5),特异度为93.6%(95% CI,92.7 - 94.4),准确度为38.6%(95% CI,37.6 - 39.6);2016年灵敏度为6.0%(95% CI,5.4 - 6.5),特异度为94.2%(95% CI,93.4 - 95.0),准确度为34.2%(95% CI,33.3 - 35.1)。总体而言,问卷的灵敏度为10%,特异度为90%,准确度为40%。

结论

尽管WSHE旨在早期识别目标疾病,但其用于胃肠道疾病问卷的灵敏度低至10%。原因在于问题本身以及目标疾病不明确的问题。未来,应改进问卷以符合WSHE的目的,并进一步明确目标疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f745/6751744/be3d036866d5/aoem-31-e8-g001.jpg

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