Can health workers diagnose dementia in the community?
Can health workers diagnose dementia in the community?
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DOI：
10.1111/j.1600-0447.2006.00923.x
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发表时间：
2007-08-01
影响因子：
6.7
通讯作者：
Prince, M. J.
中科院分区：
文献类型：
--
作者：
Jacob, K. S.;Kumar, P. Senthil;Prince, M. J.
目的：本研究试图评估由受过培训的社区卫生工作者作出的痴呆诊断的敏感性、特异性和预测值。方法：共招募了1000名65岁以上的受试者进行研究。社区卫生工作者确定了9名痴呆症患者。这是根据10/66痴呆症研究组protocol.Results：社区卫生工作者诊断的敏感性和特异性分别为3.8%和99.4%的教育调整诊断痴呆症进行了比较。假阳性率和阳性预测值分别为55.6%和44.4%。假阴性率为10.3%，阴性预测值为89.7%。针对DSM IV诊断获得了类似的值。被正确诊断的社区卫生工作者和那些其条件错过了痴呆症的主题没有显着差异的社会人口学和临床variable.Conclusion：非正式的筛查，社区卫生工作者导致敏感性低，阳性预测值。在发病率低的情况下，筛查战略并不有效。
Objective: This study attempted to evaluate sensitivity, specificity and predictive values of the diagnosis of dementia made by trained community health workers.Method: A total of 1000 subjects over the age of 65 years were recruited for the study. The community health workers identified nine subjects as having dementia. This was compared against an education adjusted diagnosis of dementia made in accordance with the 10/66 dementia research group protocol.Results: The sensitivity and specificity of the community health worker diagnosis was 3.8% and 99.4% respectively. The false positive rate and positive predictive values were 55.6% and 44.4%, respectively. The false negative rate and negative predictive value were 10.3% and 89.7% respectively. Similar values were obtained against a DSM IV diagnosis. Subjects with dementia who were correctly diagnosed by the community health workers and those whose condition was missed did not differ significantly on socio-demographic and clinical variables.Conclusion: Informal screening by community health workers resulted in low sensitivity and positive predictive values. Screening strategies in situations of low prevalence are not effective.