患者版Caprini评分与传统评分方式的一致性评价  

Consistency evaluation between patient-completed and physician-completed Caprini scores

作　　者：陈小兰 黄佳丽 刘菁轩 刘杨 方宇 张丁丁 潘磊 王勇 Chen Xiaolan;Huang Jiali;Liu Jingxuan;Liu Yang;Fang Yu;Zhang Dingding;Pan Lei;Wang Yong(Department of Respiratory and Critical Care Medicine,Beijing Shijitan Hospital,Affiliated to Capital Medical University,Beijing 100038,China;Department of Obstetrics and Gynecology,Beijing Shijitan Hospital,Beijing 100038,China;Medical Science Research Center of Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京世纪坛医院呼吸与危重症医学科,北京100038 [2]首都医科大学附属北京世纪坛医院妇产科,北京100038 [3]中国医学科学院北京协和医院医学科学研究中心,北京100730

出　　处：《中华心血管病杂志》2022年第8期811-816,共6页Chinese Journal of Cardiology

基　　金：北京市属医院科研培育计划(PX2022029);国家重大疾病多学科合作诊疗能力建设项目(2019.YLFW)。

摘　　要：目的评估患者版Caprini评分微信小程序(简称为“患者版Caprini评分”)与医师评估的Caprini评分的一致性。方法该研究为诊断性研究。连续纳入2021年2至6月首都医科大学附属北京世纪坛医院呼吸与危重症医学科、风湿免疫科、妇科和骨科的住院患者。收集入选患者的一般临床资料。在汉化的患者版Caprini评分表的基础上开发微信小程序,患者通过扫描二维码进入微信小程序,自行录入身高、体重等相关评估内容,小程序根据输入的内容自动计算分数并给出危险分层;同时,医师对于同一患者完成传统的Caprini评分并给出危险分层,对二者的一致性进行评价。结果研究共纳入患者200例,年龄(59.6±13.9)岁,女性112例(56.0%),中学及以上文化程度者184例(92.0%)。患者版Caprini评分与医师评估的Caprini评分差异无统计学意义[(4.8±2.5)分比(4.7±2.5)分,P=0.336]。患者评估所用时间比医师所用时间长[(2.4±1.2)min比(2.0±1.0)min,P<0.0001]。通过患者版和医生评估的Caprini评分得到的高危和极高危患者的人数差异无统计学意义[169(84.5%)比166(83.0%),χ^(2)=0.165,P=0.684]。Spearman相关分析结果显示患者版Caprini评分与医师评估的Caprini评分相关性良好(r=0.98,P<0.0001)。Cohen′sκ相关系数评价结果显示患者版Caprini评分与医师评估的Caprini评分所得患者危险分层的一致性极好(κ=0.97,P<0.0001)。Bland-Altman法评估结果显示仅有3.0%(6/200)的评估分数偏倚较大,不在95%置信区间之内,证明偏倚属于小概率事件,推断患者版Caprini评分与医师评估的Caprini评分的一致性较好。结论患者版Caprini评分与医师评估的Caprini评分的一致性好。Objective To evaluate the consistency of patient-completed and physician-completed Caprini scores.Methods This study was a diagnostic study.We prospectively recruited 200 inpatients(including respiratory and critical care medicine,rheumatology and immunology,obstetrics and gynecology,and orthopedics).Clinical data of the recruited patients were collected.The Wechat applet was developed based on the Chinese version of the patient-completed Caprini score.Patient could enter the Wechat applet by scanning the QR code,and enter the height,weight and other contents to the Wechat applet.The applet could automatically calculate the score and make the risk stratification according to total score.At the same time,physicians would calculate the traditional Caprini score for the same patient and make risk stratification to evaluate the consistency of scores derived from the two methods.Results The average age of these 200 patients was(59.6±13.9)years,112(56.0%)of them were female and 184(92.0%)with high school education or above.There was no significant difference between the patient-completed and physician-completed scores(4.8±2.5 vs.4.7±2.5,P=0.336).The time of physician-completed score was shorter than that of patient-completed score((2.0±1.0)minutes vs.(2.4±1.2)minutes,P<0.0001).There was no significant difference on the number of high-highest venous thromboembolism risk patients assessed by the patient-completed and the physician-completed scores:84.5%(169/200)vs.83.0%(166/200)(χ^(2)=0.165,P=0.684).There was strong positive correlations between patient-completed and physician-completed scores(r=0.98,P<0.0001).Cohen′sĸevaluation showed that the patient-completed Caprini score was in excellent consistency with physician-completed Caprini score(κ=0.97,P<0.0001).The result of Bland Altman method showed that only 3.0%(6/200)of the scores biased greatly,which was not within the 95%confidence interval,the result proved that the bias belonged to a small probability event.It was inferred that the scores of patient-comp

关 键 词：静脉血栓栓塞 危险性评估 Caprini风险评估表 

分 类 号：R543.6[医药卫生—心血管疾病]