Filippi V, Marshall T, Bulut A, Graham W, Yolsal N
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, UK.
Trop Med Int Health. 1997 Jan;2(1):47-56. doi: 10.1046/j.1365-3156.1997.d01-126.x.
In countries where population-based data on health problems are scarce, the extent of reproductive morbidity can be estimated from replies in structured interviews as a complement or as an alternative to reports from physician's examination and laboratory tests. We examined the sensitivity and specificity of detected morbidity based on these replies as compared to medical diagnoses and explored the consistency of replies when the questionnaire was administered twice, by two types of interviewers in different environments. Data were collected in a cross-sectional survey in Istanbul. The presence or absence of five morbidities, reproductive and urinary tract infections (RTI and UTI), menstrual disorders, pelvic relaxation and anaemia was determined by algorithms based on the replies, and by the physician's diagnosis. Except with anaemia, questionnaire replies were more specific than sensitive in detecting morbidity, probably partly due to many morbid conditions being accepted as normal. Sepcificity exceeded 80% for home reports of menstrual disorders (93.0%), pelvic relaxation (95.7%), RTI (abnormal discharge and pain) (81.2%) and UTI (80.7%), with the corresponding figure for anaemia at 41.7%; the best sensitivity results were for anaemia (58.3%), RTI (abnormal discharge only) (49.3%) and menstrual disorders (45.4%) with figures for pelvic relaxation and UTI reaching only 17.3 and 13.0%. Reliability between the interviews (assessed by the K coefficient), was highest at 66.1% for pelvic relaxation and lowest at 39.9% for menstrual disorders. Reliability varied between the two lay interviewers, suggesting the interviewer and the interview conditions are important. Questionnaire-based information on this type of morbidity is most useful for ascertaining perceived ill-health and only of limited use for the corresponding medically defined conditions.
在那些缺乏基于人群的健康问题数据的国家，可以通过结构化访谈的回答来估计生殖疾病的程度，以此作为医生检查和实验室检测报告的补充或替代。我们将基于这些回答所检测出的疾病发生率与医学诊断结果进行比较，考察其敏感性和特异性，并探讨在不同环境下由两类访谈者对问卷进行两次发放时回答的一致性。数据收集于伊斯坦布尔的一项横断面调查。根据回答以及医生的诊断，通过算法确定是否存在五种疾病，即生殖和尿路感染（RTI和UTI）、月经紊乱、盆腔松弛和贫血。除贫血外，问卷回答在检测疾病方面特异性高于敏感性，这可能部分是由于许多疾病状况被视为正常。月经紊乱（93.0%）、盆腔松弛（95.7%）、RTI（异常分泌物和疼痛）（81.2%）和UTI（80.7%）的家庭报告特异性超过80%，贫血的相应数字为41.7%；贫血（58.3%）、RTI（仅异常分泌物）（49.3%）和月经紊乱（45.4%）的敏感性结果最佳，盆腔松弛和UTI的数字仅为17.3%和13.0%。访谈之间的可靠性（通过K系数评估），盆腔松弛最高，为66.1%，月经紊乱最低，为39.9%。两位非专业访谈者之间的可靠性有所不同，这表明访谈者和访谈条件很重要。基于问卷的此类疾病信息对于确定自我感知的健康不佳最为有用，而对于相应的医学定义状况的用途有限。
