应用德尔菲法建立慢性阻塞性肺疾病发展“快”、“慢”的评价标准

发布时间：2018-02-09 06:42

本文关键词： 德尔菲技术肺疾病慢性阻塞性问卷调查评价标准　出处：《重庆医学》2014年09期 　论文类型：期刊论文

【摘要】：目的应用德尔菲法制定判断慢性阻塞性肺疾病(COPD)患者病情发展"快"、"慢"的评价标准。方法在前期流行病学调查、文献研究及预调查的基础上,编制2轮专家咨询表,先后发送给全疆及中华医学会呼吸病分会的20位专家进行问卷调查并进行相关统计分析。结果 2轮调查问卷的回收率均为100%,依照均数小,且变异系数大于0.3的标准,删除了第1轮发展"快"中:病程小于或等于10年,肺功能大于或等于Ⅱ级,6min步行试验1~2级,急性加重持续时间大于或等于1个月;删除了发展"慢"中:6min步行试验3~4级,急性加重时间小于或等于1周;第2轮删除了发展"快"中:病程小于或等于3年、8年,肺功能Ⅳ级,体质量指数小于21;删除了发展"慢"中:病程大于或等于10年、20年,肺功能Ⅰ级。肯德尔和谐系数随咨询次数增加而增大,经χ2检验后,差异有统计学意义(P=0.000)。结论参与调查的专家分布地区广,具有较高的专业水平和积极性,代表性较好,意见可信度高,协调性好,其预测结果可取。COPD病情发展"快""慢"评价标准的框架及条目基本得到专家认可,但在年急性发作次数、年住院次数、体质量指数指标的修改、取舍上尚存在不同意见,需进一步研究。
[Abstract]:Application of Delphi method to determine the chronic obstructive pulmonary disease (COPD) patients with "fast" and "slow" evaluation standard. In the early stage of epidemiological investigation method, literature research foundation and pre survey, the preparation of the 2 round of expert consultation table, has sent 20 experts of respiratory diseases branch of Xinjiang and Huayi learn the questionnaire and related statistical analysis. Results the recovery of the 2 round of the questionnaire are in accordance with the rate of 100%, the number is small, and the coefficient of variation is greater than 0.3 of the standard, the deletion of the first round of development "fast" in the course of less than or equal to 10 years, lung function is equal to or greater than grade II, 6min walking test 1~2, acute exacerbation duration is greater than or equal to 1 months; the development of "slow" delete: 6min walk test 3~4 level less than or equal to 1 weeks of acute exacerbation; second deleted: "fast" development course of less than or equal to 3 years, 8 years, class IV lung function, body quality The index is less than 21; the development of "slow" delete: 20 years duration is greater than or equal to 10 years, grade I lung function. The Kendall coefficient increases with the increase of the number of consultation, the 2 test, the difference was statistically significant (P=0.000). Conclusion the experts involved in the investigation of widely distribution, professional level and positive with a higher, better representative opinions, high credibility, good coordination, the prediction framework and item results desirable.COPD condition development "fast" and "slow" the basic evaluation criteria recognized by the experts, but in the years the number of acute attack, years of hospitalization, body mass index changes, there are still different opinions choice that needs further study.

【作者单位】：国家中医临床研究基地;新疆医科大学附属中医医院呼吸科;
【基金】：国家自然科学基金资助项目(81260590)
【分类号】：R563.9

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