流行病学研究中，比较三种方法对哮喘的检测：来自丹麦国家出生队列研究
2012/07/06
摘要
哮喘是一种异质性疾病，怎样在流行病学研究中对哮喘进行检测，以更好地抓住其临床特征，目前尚不清楚。
本试验在丹麦国家出生队列研究中比较3种哮喘的检测方法。在儿童7岁时，基于父母主诉的医生诊断、以人群为基础的住院登记中ICD-10诊断和以人群为基础的哮喘治疗处方相关数据，通过自填式问卷调查，估计哮喘患病率。对方法异质性采用kappa统计分析。哮喘治疗处方分析显示的哮喘患病率最高（32.2%），其次为自我主诉分析（12.0%）和住院登记分析（6.6%）。任何两种方法之间存在明显的非重叠（kappa = 0.21-0.38）。如果联合采用3种方法，哮喘患病率为3.6%。
我们结果显示，对同一儿童队列采用自我主诉哮喘、住院登记的ICD-10诊断和抗哮喘治疗处方分析哮喘的患病率，结果存在差异。各方法间存在非重叠，这可能与不同方法具有鉴别不同哮喘表现型有关，因此，在未来的病因学研究中，这些患者需要针对相应表现型采用不同的治疗方案。
（刘国梁 审校）
PLoS One. 2012;7(5):e36328. Epub 2012 May 11.
PLoS One. 2012;7(5):e36328. Epub 2012 May 11.
Source
Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Abstract
Asthma is a heterogeneous outcome and how the condition should be measured to best capture clinically relevant disease in epidemiologic studies remains unclear. We compared three methods of measuring asthma in the Danish National Birth Cohort (n>50.000). When the children were 7 years old, the prevalence of asthma was estimated from a self-administered questionnaire using parental report of doctor diagnoses, ICD-10 diagnoses from a population-based hospitalization registry, and data on anti-asthmatic medication from a population-based prescription registry. We assessed the agreement between the methods using kappa statistics. Highest prevalence of asthma was found using the prescription registry (32.2%) followed by the self-report (12.0%) and the hospitalization registry (6.6%). We found a substantial non-overlap between the methods (kappa = 0.21-0.38). When all three methods were combined the asthma prevalence was 3.6%. In conclusion, self-reported asthma, ICD-10 diagnoses from a hospitalization registry and data on anti-asthmatic medication use from a prescription registry lead to different prevalences of asthma in the same cohort of children. The non-overlap between the methods may be due to different abilities of the methods to identify cases with different phenotypes, in which case they should be treated as separate outcomes in future aetiological studies.
PLoS One. 2012;7(5):e36328. Epub 2012 May 11.
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无症状哮喘患者中嗜酸性粒细胞计数和乙酰甲胆碱激发试验的相关性
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