儿童哮喘筛查问卷合理性以及信度和效度分析  

Rationale,reliability and validity of childhood asthma screening questionnaire

作　　者：张业武[1,2] 刘新学[2] 叶荣伟[2] 李竹[2] 

机构地区：[1]中国疾病预防控制中心公共卫生监测与信息服务中心,北京100050 [2]北京大学生育健康研究所,北京100083

出　　处：《中国儿童保健杂志》2010年第2期96-99,共4页Chinese Journal of Child Health Care

基　　金：中国博士后科学基金(57034)

摘　　要：【目的】对自行设计的儿童哮喘筛查问卷的合理性以及其信度和效度进行评价。【方法】利用试点监测研究基线调查和初次监测结果数据以及既往医疗机构诊断的儿童哮喘病例等对儿童哮喘筛查问卷的效度和信度进行评价。【结果】筛查表项目前后两次重复检测结果具有较好的一致性,Kappa>0.5,相关系数最高为0.82。以既往临床诊断为金标准,筛查表各项指标特异度都超过98.5;灵敏度相差较大,其中既往喘息症状最高为91.3%,慢性咳嗽症状最低,仅为17.4%。哮喘可疑病例项敏感度为100%,特异度为98.5%,阳性预测值为39.5%,阴性预测值为98.5%;以病例对照研究的病例作为金标准,喘息症状项的灵敏度最高,为77.3%;慢性咳嗽症状项灵敏度最低,为9.9%。特异度除夜间咳嗽项为92.1%外,其他项目都超过95%。哮喘可疑病例项的敏感度为95.6%,特异度为90.1%,阳性预测值为21.8%,阴性预测值为95.3%。【结论】儿童哮喘筛查问卷具有良好信度和效度。该问卷为基于人群的儿童哮喘监测以及流行病学研究中病例初步筛查工作提供了有效的工具。[Objective] To evaluate the rationale, reliability and validity of the self-designed childhood asthma screening questionnaire. [Method] Data from baseline surveys, pilot asthma surveillance studies, as well as the previously diagnosed childhood asthma cases by hospitals were used for analysis of the validity and reliability of the childhood asthma screening questionnaire. [Results] High consistence for asthma screening questionnaire was found between baseline screening and pilot asthma surveillance with Kappa coefficient more than 0.5. Significant correlations were found between two times of screening with the highest correlation coefficient 0.82. By taking the previous doctor-diagnosed asthma as gold standard, the specificities of four core questions were more than 98.5 %. The sensitivity varied greatly with highest 91.3 % for wheezing and lowest 17.4% for chronic cough. The sensitivity was 100 %, specificity 98.5 %, positive predictive value 39.5%, and negative predictive value 98. 5% for possible asthma cases. While validating the asthma screening questionnaire in case-control study, we found that the sensitivity of wheezing was highest （77.3%） and chronic cough lowest （9.9%）. Except for night wake-up （92.1%）, the specificities of other core questions were over 95%. The sensitivity for the possible asthma item was 95.6%, specificity 90.0%. And the positive predictive value was 21.8%, and negative predictive value 98.5% based the estimated prevalence of asthma 2.8% in the study population. [Conclusions] The reliability and validity of the self-designed childhood asthma screening questionnaire are high, thus it may serve as a reliable tool for identification of asthma cases for the population-based asthma surveillance system and epidemiological studies.

关 键 词：儿童哮喘 筛查表 效度 信度 儿童哮喘监测 

分 类 号：R723.94[医药卫生—儿科]