3个版本哮喘控制问卷调查中有关哮喘控制的临界值
2010/11/04
摘要
简介：哮喘控制问卷调查（ACQ）可用于对哮喘控制进行评价。本文旨在研究临床使用的3个版本的ACQ中，能区分不同类型哮喘控制的最佳临界值。
材料与方法：对象为西班牙43个门诊的607名成人哮喘患者（61%女性）。患者根据哮喘严重程度分层，采用流行病学方法进行评价。为获得最佳临界值，计算每个版本的ACQ（ACQ-FEV1, ACQ-PEF及ACQ-wLF [不检测肺功能]）受试者工作特征曲线（ROC）下敏感性、特异性和阳性、阴性预测值（PPV和NPV）。
结果：ACQ-FEV1的临界值为1.14 (8分/7项目)、ACQ-PEF为1.28（9分/7项目）、ACQ-wLF为0.83（5分/6项目），正确分类的患者百分比分别为76.5%, 77.3%和77.2%。3个版本ACQ的曲线下面积分析显示，ACQ-wLF的曲线下面积大于ACQ-FEV1（P=0.004）。如果评分位于1.14至1.57 （ACQ-FEV1）、1.28 至1.57（ACQ-PEF）以及0.83至1.5（ACQ-wLF）之间时，认为患者哮喘具有一定程度控制。
结论：本研究真实反映了临床实践，结果显示，3个版本的ACQ对与哮喘控制较佳的定义存在不同的临界值。
（苏楠 审校）
J Asthma. 2010 Sep 17. [Epub ahead of print]
Cut-off points for defining asthma control in three versions of the Asthma Control Questionnaire.
Sastre J, Olaguibel J, Vega JM, Del Pozo V, Picado C, Lopez Viña A.
Fundación Jimenez Díaz, Alergia, Madrid, Spain.
Abstract
Introduction. The Asthma Control Questionnaire(TM) (ACQ) was developed to assess asthma control. The objective of this study is to determine the cut-off points that best differentiate between several types of asthma control in three versions of the ACQ used in clinical practice.
Materials and methods. It appears 607 adult asthmatic patients (61% female) were recruited from 43 outpatient clinics in Spain. Once the patients were stratified by severity of asthma, they were then evaluated in an epidemiological study. To determine the optimum cut-off points, the area under the receiver operating characteristics (ROC) curve, as well as sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively), was calculated for each version of the ACQ (ACQ-FEV(1) (forced expiratory volume in the first second), ACQ-PEF (peak expiratory flow), and ACQ-wLF (without lung function)).
Results. The optimal cut-off for ACQ-FEV(1) was 1.14 (the sum of 8 points/7 items), for ACQ-PEF 1.28 (the sum of 9 points/7 items), and for ACQ-wLF 0.83 (the sum of 5 points/6 items), and the percentage of correctly classified patients was 76.5%, 77.3%, and 77.2%, respectively. A comparison of ROCs obtained from the three versions of the ACQ shows that ACQ-wLF had a significantly greater area under the curves (AUC) (p = .004) than ACQ-FEV(1). Patients were considered as having some control if their ACQ-FEV(1) score fell between 1.14 and 1.57, if ACQ-PEF values were between 1.28 and 1.57, or if ACQ-wLF scores ranged between 0.83 and 1.5.
Conclusions. Our study, which was carried out in a manner which more closely reflects clinical practice, reveals differences in cut-offs used to define well-controlled asthma among three versions of the ACQ.
J Asthma. 2010 Sep 17. [Epub ahead of print]
简介：哮喘控制问卷调查（ACQ）可用于对哮喘控制进行评价。本文旨在研究临床使用的3个版本的ACQ中，能区分不同类型哮喘控制的最佳临界值。
材料与方法：对象为西班牙43个门诊的607名成人哮喘患者（61%女性）。患者根据哮喘严重程度分层，采用流行病学方法进行评价。为获得最佳临界值，计算每个版本的ACQ（ACQ-FEV1, ACQ-PEF及ACQ-wLF [不检测肺功能]）受试者工作特征曲线（ROC）下敏感性、特异性和阳性、阴性预测值（PPV和NPV）。
结果：ACQ-FEV1的临界值为1.14 (8分/7项目)、ACQ-PEF为1.28（9分/7项目）、ACQ-wLF为0.83（5分/6项目），正确分类的患者百分比分别为76.5%, 77.3%和77.2%。3个版本ACQ的曲线下面积分析显示，ACQ-wLF的曲线下面积大于ACQ-FEV1（P=0.004）。如果评分位于1.14至1.57 （ACQ-FEV1）、1.28 至1.57（ACQ-PEF）以及0.83至1.5（ACQ-wLF）之间时，认为患者哮喘具有一定程度控制。
结论：本研究真实反映了临床实践，结果显示，3个版本的ACQ对与哮喘控制较佳的定义存在不同的临界值。
（苏楠 审校）
J Asthma. 2010 Sep 17. [Epub ahead of print]
Cut-off points for defining asthma control in three versions of the Asthma Control Questionnaire.
Sastre J, Olaguibel J, Vega JM, Del Pozo V, Picado C, Lopez Viña A.
Fundación Jimenez Díaz, Alergia, Madrid, Spain.
Abstract
Introduction. The Asthma Control Questionnaire(TM) (ACQ) was developed to assess asthma control. The objective of this study is to determine the cut-off points that best differentiate between several types of asthma control in three versions of the ACQ used in clinical practice.
Materials and methods. It appears 607 adult asthmatic patients (61% female) were recruited from 43 outpatient clinics in Spain. Once the patients were stratified by severity of asthma, they were then evaluated in an epidemiological study. To determine the optimum cut-off points, the area under the receiver operating characteristics (ROC) curve, as well as sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively), was calculated for each version of the ACQ (ACQ-FEV(1) (forced expiratory volume in the first second), ACQ-PEF (peak expiratory flow), and ACQ-wLF (without lung function)).
Results. The optimal cut-off for ACQ-FEV(1) was 1.14 (the sum of 8 points/7 items), for ACQ-PEF 1.28 (the sum of 9 points/7 items), and for ACQ-wLF 0.83 (the sum of 5 points/6 items), and the percentage of correctly classified patients was 76.5%, 77.3%, and 77.2%, respectively. A comparison of ROCs obtained from the three versions of the ACQ shows that ACQ-wLF had a significantly greater area under the curves (AUC) (p = .004) than ACQ-FEV(1). Patients were considered as having some control if their ACQ-FEV(1) score fell between 1.14 and 1.57, if ACQ-PEF values were between 1.28 and 1.57, or if ACQ-wLF scores ranged between 0.83 and 1.5.
Conclusions. Our study, which was carried out in a manner which more closely reflects clinical practice, reveals differences in cut-offs used to define well-controlled asthma among three versions of the ACQ.
J Asthma. 2010 Sep 17. [Epub ahead of print]
上一篇：
哮喘、COPD急性加重时呼出气冷凝液中PH测定
下一篇：
通过哮喘严重程度进行儿童哮喘临床分型
