文摘

背景:串行呼气流量(PEF)峰值测量通常是最合适的职业性哮喘的确认的第一步。视觉评估策划记录更敏感和具体的统计方法到目前为止报道。使用视觉分析缺乏广泛的专业知识是有限的方法。计算机辅助诊断援助(OASYS-2)开发基于评分系统由视觉分析。这消除了要求有经验的翻译,应该导致更广泛使用的技术。方法:收集PEF记录从工人参加调查的职业性肺部疾病临床疑似职业性哮喘和呼吸道症状的工人参与一项研究邮政分拣的办公室。PEF记录被分成两个发展集和两个黄金标准集。后者包括记录工人所达成了最后的诊断方法除了PEF录音。一个有经验的观察者取得个人工作和休息时间两个发展设置PEF记录;线性判别分析是用来比较测量取自发展集1记录与视觉的分数。 Two equations were produced which allowed prediction of scores for individual work or rest periods. The development set 2 was used to determine how these scores should be used to produce a whole record score. The first gold standard set was used to determine the whole record score which best separated those with and without occupational asthma. The second set determined the sensitivity and specificity of the chosen score. RESULTS: Two hundred and sixty eight PEF records were collected from 169 workers and divided into two development sets (81 and 60 records) and two gold standard sets (60 and 67 records). Linear discriminant analysis produced equations predicting the score for work periods incorporating five indices of PEF change and one for rest periods using seven indices. These equations correctly predicted the score for development set 1 work and rest periods on 61% of occasions (kappa = 0.47). The whole record score for development set 2 records, after weighting for definite or definitely no occupational effect, correlated with the visual score (correlation coefficient 0.86). Comparison with gold standard set 1 identified a cut off which proved to have a sensitivity of 75% and a specificity of 94% for an independent diagnosis of occupational asthma when applied to gold standard set 2. CONCLUSIONS: These results suggest that the sensitivity and specificity of analysing PEF records for occupational asthma using OASYS-2 approaches that of visual analysis, but it should be absolutely reproducible. The performance of OASYS-2 is more specific and approaches the sensitivity of other statistical methods of analysis. The evaluation of a large number of PEF records from workers exposed to different sensitising agents suggests that these results should be robust and should be repeatable in clinical practice.