自拟问卷用于社区 COPD 筛查的效果。
Efficacy of a Self-Designed Questionnaire for Community Screening of COPD.
机构信息
Department of General Medicine, Jiangchuan Community Healthcare Service Center of Minhang District, Shanghai, People's Republic of China.
Department of Respiratory and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, People's Republic of China.
出版信息
Int J Chron Obstruct Pulmon Dis. 2022 Jun 14;17:1381-1391. doi: 10.2147/COPD.S359098. eCollection 2022.
PURPOSE
To evaluate the screening efficacy of a self-designed questionnaire for chronic obstructive pulmonary disease (COPD) and the potential gender disparity in its efficacy.
PATIENTS AND METHODS
A screening questionnaire, the COPD Screening Questionnaire-Minhang (COPD-MH), was designed with reference to the self-scored COPD population screener (COPD-PS) and the COPD screening questionnaire (COPD-SQ), incorporating characteristics of the local population in Shanghai, China. The revised questionnaire included only five questions. Each question scored 0-4, with a highest total score of 20. The COPD-PS and COPD-SQ comprised 5 and 7 questions, respectively. Their scoring criteria were not consecutive integers and, thus, not easily counted. The COPD-MH focused on symptoms, and each item was set the same answers for convenience. Screening for COPD was conducted among residents over 40 years old in a community in Shanghai using the three aforementioned questionnaires. Each participant also received spirometry tests. A receiver operator characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to assess the validity of each questionnaire.
RESULTS
A total of 1197 community residents in Minhang District completed the screening. A total of 1023 participants were finally included in analysis with a detected prevalence of 12.4% for COPD. The best cut-off values for the COPD-PS, COPD-SQ, and COPD-MH were 4, 16, and 7 points, respectively. The AUCs for these three questionnaires were >0.5, but the sensitivity of the COPD-MH was higher than those of the COPD-PS and COPD-SQ. The sensitivity of COPD-MH was 80.77% for males and 77.5% for females. The COPD-MH had higher diagnostic efficiency and higher sensitivity with gender-specific cut-off values.
CONCLUSION
The COPD-MH is comparable to and less time-consuming than the existing screening methods for COPD. Gender-related factors affect the optimal cut-off values of the COPD screening questionnaire, and rectifying this can improve the practical screening efficacy.
目的
评估自行设计的慢性阻塞性肺疾病（COPD）问卷的筛查效果及其在疗效上的潜在性别差异。
方法
本研究设计了一种筛查问卷，即 COPD 筛查问卷-闵行（COPD-MH），参考了自评 COPD 人群筛查工具（COPD-PS）和 COPD 筛查问卷（COPD-SQ），并结合了中国上海当地人群的特点。修订后的问卷仅包含 5 个问题。每个问题的得分为 0-4 分，最高总分为 20 分。COPD-PS 和 COPD-SQ 分别包含 5 个和 7 个问题，评分标准不是连续整数，因此不易计数。COPD-MH 主要关注症状，为方便起见，每个项目设置相同的答案。采用上述三种问卷对上海某社区 40 岁以上居民进行 COPD 筛查。每位参与者还接受了肺功能测试。绘制受试者工作特征（ROC）曲线，计算曲线下面积（AUC）评估每个问卷的有效性。
结果
闵行区共有 1197 名社区居民完成了筛查。最终共有 1023 名参与者纳入分析，COPD 检出率为 12.4%。COPD-PS、COPD-SQ 和 COPD-MH 的最佳截断值分别为 4、16 和 7 分。这三个问卷的 AUC 值均>0.5，但 COPD-MH 的灵敏度高于 COPD-PS 和 COPD-SQ。COPD-MH 对男性的灵敏度为 80.77%，对女性的灵敏度为 77.5%。COPD-MH 具有更高的诊断效率和性别特异性截断值下更高的灵敏度。
结论
COPD-MH 与现有的 COPD 筛查方法相当，且耗时更短。性别相关因素影响 COPD 筛查问卷的最佳截断值，纠正这一点可以提高实际筛查效果。
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