The predictive value of influenza symptomatology in elderly people
The predictive value of influenza symptomatology in elderly people
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DOI：
10.1093/fampra/15.1.16
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发表时间：
1998-02-01
期刊：
影响因子：
2.2
通讯作者：
Knottnerus, JA
中科院分区：
文献类型：
--
作者：
Govaert, TME;Dinant, GJ;Knottnerus, JA
Objective.我们的目的是确定复杂的症状，这对流感的诊断具有最高的预测价值。一项关于60岁及以上患者流感病毒学的问卷调查研究（n = 1838）。34名参与研究的全科医生记录了因流感样症状就诊的患者的口腔病学。GP的诊断结论的有效性，以及初级保健中的健康问题的国际分类（ICHPPC-2）和在荷兰的哨兵站的标准的诊断有效性，确定与预测值和比值比的帮助下，使用血清学证实的流感作为金标准。同样的方法也被用来确定哪种综合症状对流感的预测价值最高。采用Logistic回归分析对结果进行验证。GP诊断的预测值为35%。根据两种分类方法的标准，诊断的预测值分别为24%（哨兵站）和18%（ICHPPC-2）。在个体症状中，发热、咳嗽和急性起病的组合对流感诊断的预测价值最高（30.3%）。建议以下列方式调整荷兰哨点站和第二次国际流行性感冒预防控制中心的标准：如果在所有综合症状中，至少出现发热、咳嗽和急性发作，则可能是流行性感冒。
Objective. We aimed to determine the complex of symptoms which has the highest predictive value for the diagnosis of influenza.Method. A questionnaire study with questions regarding the symptomatology of influenza among patients aged 60 and older (n = 1838). Thirty-four participating GPs recorded the symptomatology of patients who came to their general practice with influenza-like complaints. The validity of the diagnostic conclusion of the GP, as well as the diagnostic validity of the criteria of the International Classification of Health Problems in Primary Care (ICHPPC-2) and the Sentinel Stations in The Netherlands, was determined with the help of the predictive value and odds ratio, using serologically confirmed influenza as the gold standard. The same method was used to determine which complex of symptoms has the highest predictive value for influenza. The results were verified using logistic regression analysis.Results. The predictive value of the diagnostics of the GP amounted to 35%. The predictive values of the diagnostics according to the criteria of the two classification methods were 24% (Sentinel Stations) and 18% (ICHPPC-2). Of the individual symptoms, the combination of fever, coughing and acute onset had the highest predictive value (30.3%) for the diagnosis of influenza.Conclusion. It is recommended that the criteria of the Sentinel Stations in The Netherlands and the ICHPPC-2 be adapted in the following way: influenza is likely if, out of the entire complex of symptoms, at least fever, coughing and an acute onset occur.