Risk of chronic obstructive pulmonary disease. Collaborative assessment of the validity of the Tecumseh index of risk.
Risk of chronic obstructive pulmonary disease. Collaborative assessment of the validity of the Tecumseh index of risk.
复制标题
慢性阻塞性肺疾病的风险。
DOI：
10.1164/arrd.1984.130.3.380
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Lebowitz,MD
中科院分区：
文献类型：
--
作者：
Higgins,MW;Keller,JB;Landis,JR;Beaty,TH;Burrows,B;Demets,D;Diem,JE;Higgins,IT;Lakatos,E;Lebowitz,MD
在密歇根州特库姆塞人群的前瞻性流行病学研究中确定了慢性阻塞性肺疾病（COPD）的预测因子。10年内发生COPD的风险可以从包括年龄、性别、吸烟习惯和一秒用力呼气量（FEV1）作为风险因素的概况中估计。风险指数将63%的男性发病病例和64%的女性发病病例置于特库姆塞风险分布的前10%，将81%的男性和86%的女性COPD病例置于风险分布的前20%。特库姆塞风险指数对其他人群的有效性是在对巴尔的摩、波士顿、佛罗里达、路易斯安那、斯塔弗利和图森的纵向流行病学研究中收集的数据进行合作调查中确定的。通过比较每个人群中COPD的预测（或预期）发作与每个研究中的观察结果，评估风险模型拟合这些数据集的程度。在特库姆塞中确定的COPD预测因子也被证明是其他人群中最重要的风险因素。指数的拟合优度总体上令人满意。在所有人群中，高风险评分与COPD发病率增加相关，从而证实了风险指数的预测能力，特库姆塞风险指数提供了一种实用的方法，用于从标准问题的答案和简单的肺功能测试中制定风险特征。肺功能降低的重度吸烟者的风险最大，戒烟或减少吸烟量的吸烟者的风险较低，而肺功能高于平均水平的非吸烟者的风险最低。由于吸烟是主要的可补救的风险因素，识别高风险男性和女性的能力意味着向公众提供的反吸烟建议可以与对易感人群采取更有力的方法相结合。
Predictors of chronic obstructive pulmonary disease (COPD) have been identified in the prospective epidemiologic study of the population of Tecumseh, Michigan. Risk of developing COPD within 10 yr can be estimated from a profile that includes as risk factors age, sex, cigarette smoking habits, and forced expiratory volume in one second (FEV1. The index of risk placed 63% of male incidence cases and 64% of female incidence cases in the top 10% of the risk distribution and 81% of male and 86% of female COPD cases in the top 20% of the risk distribution for Tecumseh. The validity of the Tecumseh index of risk for other populations was determined in a collaborative investigation of data collected in longitudinal epidemiologic studies in Baltimore, Boston, Framingham, Louisiana, Staveley, and Tucson. The extent to which the risk model fitted these data sets was assessed by comparing predicted (or expected) onsets of COPD in each population with observations made in each study. The predictors of COPD identified in Tecumseh were shown to be the most important risk factors in the other populations as well. The goodness-of-fit of the index was satisfactory overall. In all populations, a high risk score was associated with an increased incidence of COPD, thus confirming the predictive ability of the risk index.The Tecumseh index of risk provides a practical method for developing a risk profile from answers to standard questions and simple tests of lung function. Risks are greatest for heavy cigarette smokers with reduced lung function, lower in smokers who stop smoking or reduce their cigarette consumption, and lowest of all in nonsmokers with above average lung function. Because cigarette smoking is the principal remediable risk factor, ability to identify high-risk men and women means that antismoking advice to the general public can be combined with a more vigorous approach to susceptible persons.