基于德尔菲法的慢性阻塞性肺疾病稳定期疗效评价指标体系的建立  

Establishment of Efficacy Evaluation Index System for Chronic Obstructive Pulmonary Disease in Stabilization Period Based on Delphi Method

作　　者：王明航[1] 李建生[1,2] 李素云[1] 余学庆[1] 

机构地区：[1]河南中医学院第一附属医院,河南省郑州市人民路19号450003 [2]河南中医学院老年医学研究所

出　　处：《中医杂志》2013年第14期1200-1203,共4页Journal of Traditional Chinese Medicine

基　　金："十一五"国家科技支撑计划资助项目(2006BA104A13-02);国家自然科学基金资助项目(81102665);河南省科技攻关计划资助项目(112102310148);河南省教育厅科技攻关计划资助项目(2011B360009)

摘　　要：目的通过专家问卷筛选疗效评价指标,构建慢性阻塞性肺疾病(COPD)稳定期疗效评价指标体系。方法制定COPD稳定期疗效评价专家调查问卷,遴选呼吸领域有影响的专家50名,采用信函法进行调查,回收问卷建立数据库,运用德尔菲法进行评价,采用均数和满分率评价专家意见集中程度,采用百分权重法对各结局指标进行赋权。结果发放问卷50份,回收50份,专家积极系数为100%。COPD稳定期临床疗效评价指标体系主要包括临床相关指标、生存质量、实验室指标、中医证候相关指标、经济学指标、综合评价指标等内容;专家意见相对集中的评价指标(均数≥4.5分)有急性加重次数、第一秒用力呼气容积、喘息、BODE指数、再住院率、第一秒用力呼气容积与用力肺活量的比值、二氧化碳分压、圣乔治呼吸疾病问卷、急性加重间隔时间、急性加重严重程度;组合权重≥0.017的评价指标有中医证候相关指标、经济学指标、BODE指数、SAFE指数、最小临床意义变化值、圣乔治呼吸疾病问卷、肺功能状态与呼吸困难问卷、肺疾病生存质量量表、肺功能状态量表。结论基于专家问卷构建的COPD稳定期疗效评价指标体系,包括医护人员注重的指标、患者注重的指标、实验室指标、中医证候相关指标等四类指标。Objective To establish the efficacy evaluation index system for chronic obstructive pulmonary disease （COPD） in stabilization period based on expert questionnaire. Methods The expert questionnaire was designed and 50 experts were investigated. The questionnaires were collected to establish a database. The Delphi method was used. The concentration degree of expert opinions was evaluated with mean and full mark rate. The outcome indicators were empowered with percentage weighting method. Results Fifty questionnaires were sent out and 50 questionnaires were returned. The expert active factor was 100%. The efficacy evaluation index system for COPD in stabilization period included clinically relevant indicators, quality of life, laboratory parameters, pattern related indicators, economic indicators and comprehensive evaluation. The relatively concentrated evaluation index of expert advice （mean≥4.5 points） was acute exacerbations, forced expiratory volume in one second, wheezing, BODE index, readmission rates, forced expiratory volume in one second and forced vital capacity ratio, partial pressure of carbon dioxide, St. George＇s Respiratory Questionnaire （SGRQ）, acute exacerbation interval and acute increased severity. The relatively concentrated evaluation index of expert advice （weight ≥ 0. 017） was patterns related indicators, economic indicators, BODE index, SAFE index, smallest changes in the value of clinical significance, SGRQ, pulmonary function and dyspnea questionnaire, Quality of Life Scale for Lung Disease and Pulmonary Status Scale. Conclusion The efficacy evaluation index system for COPD in stabilization period based on expert questionnaire includes indicators of medical attention, indicators of patient attention, laboratory parameters and TCM pattern related indicators.

关 键 词：德尔菲法 慢性阻塞性肺疾病 疗效评价指标 

分 类 号：R563.9[医药卫生—呼吸系统]