Assessing pediatric tobacco exposure using parent report: comparison with hair nicotine
Assessing pediatric tobacco exposure using parent report: comparison with hair nicotine
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DOI：
10.1038/s41370-018-0051-z
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发表时间：
2018-11-01
影响因子：
4.5
通讯作者：
Wilson, Karen
中科院分区：
文献类型：
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作者：
Groner, Judith A.;Rule, Ana M.;Wilson, Karen
引言
本研究旨在利用头发尼古丁水平检验二手烟（SHS）暴露筛查问题与生物标志物结果之间的关系。我们的最终目标是在儿科临床环境中开发敏感且有效的二手烟暴露筛查工具。
方法
研究人员制定了一组关于暴露的核心问题。来自两项分别针对健康儿童和患有支气管肺发育不良（BPD）儿童的正在进行的研究的数据被用于评估回答与头发尼古丁水平之间的一致性。检验了敏感性、阳性预测值和准确性。
结果
在两个人群中没有单个具有相似敏感性的问题。对两组而言阳性预测值最高（健康组为90.8%，BPD组为84.6%）的问题是儿童在过去7天内是否在家中暴露于吸烟环境。对两组而言准确性最高的问题是家中吸烟者的数量（0个与≥1个），健康儿童的准确性为72.4%，BPD组为79.0%。
结论
特定问题的表现存在很大差异。这些数据表明，一种“一刀切”的二手烟暴露筛查方法可能并不适用于所有儿科人群。
Introduction The purpose of this study was to examine the relationships between screening questions for secondhand smoke (SHS) exposure and biomarker results using hair nicotine levels. Our ultimate goal was to develop sensitive and valid screening tools in pediatric clinical settings for SHS exposure.Methods Investigators developed a core set of questions regarding exposure. Data from two separate ongoing studies of well children and those with bronchopulmonary dysplasia (BPD) were used to assess the concordance between responses and hair nicotine levels. Sensitivity, a positive predictive value, and accuracy were examined.Results There was no single question with similar sensitivity in both populations. The question with the highest positive predictive value (90.8% well-cohort and 84.6% BPD cohort) for both the groups was whether the child had been exposed to in-home smoking in the last 7 days. The question with the highest accuracy for both groups was the number of smokers at home (0 vs >= 1), with an accuracy of 72.4% for well children and 79.0% for the BPD cohort.Conclusions There was a wide variability in the performance of specific questions. These data demonstrate that a "one-size-fits-all" approach to screening for secondhand tobacco smoke exposure may not be appropriate for all pediatric populations.