Prediction of colorectal cancer by a patient consultation questionnaire and scoring system: a prospective study
Prediction of colorectal cancer by a patient consultation questionnaire and scoring system: a prospective study
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DOI：
10.1016/s0140-6736(02)09549-1
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发表时间：
2002-07-27
期刊：
影响因子：
168.9
通讯作者：
Cade, D
中科院分区：
文献类型：
--
作者：
Selvachandran, SN;Hodder, RJ;Cade, D
背景目前NHS关于有结直肠症状患者转诊的指南将许多患者归类为高风险，但未能在低风险组中识别出大量癌症。我们描述了一个实用的评分方法来预测结直肠cancer.Methods从1999年10月，2268例患者的远端结肠症状，由全科医生，完成了一个病人的咨询问卷连接到一个计算机化的记录。由高级结直肠外科医生根据全科医生的信函和调查问卷中的恶性肿瘤风险评分对转诊进行优先排序。加权的数值得分来自主要症状和症状复合物的加权，并在问卷数据输入计算机程序时自动计算。通过受试者操作特征分析评估评分系统。评分系统的敏感性和特异性进行了比较与McNemar的test.Findings的2268例患者，95结直肠癌。癌症患者的平均加权数值评分显著高于非癌症患者（平均值76.5 [95%CI 72.2-80.9] vs 44.5 [43.6-45.4]; p
Background Current NHS guidelines for referral of patients with colorectal symptoms classify many as high risk but fail to identify a significant number of cancers in the low-risk group. We describe a practical scoring method to predict colorectal cancers.Methods From October, 1999, 2268 patients with distal colonic symptoms, referred by general practitioners, completed a patient consultation questionnaire linked to a computerised record. Referrals Were prioritised with a malignancy risk score by a senior colorectal surgeon separately from the general practitioner's letter and from the questionnaire. A weighted numerical score was derived from weighting of primary symptoms and symptom complexes and was calculated automatically when the questionnaire data were entered into the computer program. Analysis by receiver-operating characteristics assessed the scoring systems. Sensitivities and specificities of scoring systems were compared with McNemar's test.Findings Of the 2268 patients, 95 had colorectal cancer. The average weighted numerical score was significantly higher for patients with cancer than for non-cancer patients (mean 76.5 [95% CI 72.2-80.9] vs 44.5 [43.6-45.4]; p