| 曾令佳,杨雯雯,帖萍,刘新荣,高秀容,李振宇,侯平,智尹,白永飞,耿梦杰,陈秋兰,崔步云,李中杰,王丽萍.山西省医疗机构2015年布鲁氏菌病诊断与报告质量调查[J].Chinese journal of Epidemiology,2017,38(11):1480-1483 |
| 山西省医疗机构2015年布鲁氏菌病诊断与报告质量调查 |
| Investigation of human brucellosis diagnosis and report quality in medical institutions in key areas of Shanxi province |
| Received:February 07, 2017 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.11.008 |
| KeyWord: 人布鲁氏菌病 诊断 报告质量 |
| English Key Word: Human brucellosis Diagnosis Report quality |
| FundProject: |
| Author Name | Affiliation | E-mail | | Zeng Lingjia | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Yang Wenwen | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Preventive Medical Information Institute, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China | | | Tie Ping | Shanxi Provincial Center for Disease Control and Prevention, Taiyuan 030012, China | | | Liu Xinrong | Datong Center for Disease Control and Prevention, Datong 037008, China | | | Gao Xiurong | Xinzhou Center for Disease Control and Prevention, Xinzhou 034000, China | | | Li Zhenyu | Datong Center for Disease Control and Prevention, Datong 037008, China | | | Hou Ping | Datong Center for Disease Control and Prevention, Datong 037008, China | | | Zhi Yin | Xinzhou Center for Disease Control and Prevention, Xinzhou 034000, China | | | Bai Yongfei | Shanxi Provincial Center for Disease Control and Prevention, Taiyuan 030012, China | | | Geng Mengjie | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Chen Qiulan | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Cui Buyun | National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Li Zhongjie | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Wang Liping | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | wanglp@chinacdc.cn |
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| Abstract: |
| 目的 评估山西省医疗机构布鲁氏菌病（布病）诊断报告的准确性，了解临床医生对该病诊断标准的掌握情况。方法 对山西省布病重点地区的6家医疗机构开展现场调查。采用系统抽样方法，回顾性收集复核2015年所报告布病病例的诊断依据资料，评价其诊断报告准确性。采取问卷方法集中对被调查医疗机构从事该病诊疗的临床医生开展调查，评估其诊断报告知识的掌握情况。采用Excel 2010软件建立数据库，用R 3.3.2软件进行描述性分析和统计学检验。结果 现场复核377例布病病例，诊断符合率为70.8%（267/377），其中市级医疗机构诊断符合率为77.0%（127/165），县级医疗机构诊断符合率为66.0%（140/212），差异有统计学意义（χ2=5.4，P=0.02）。复核病例中，实验室确诊病例诊断符合率为87.1%（256/294），而临床诊断病例诊断符合率仅为13.3%（11/83），差异有统计学意义（χ2=170.7，P<0.001）。被调查的21名临床医生，对布病疑似病例、临床诊断病例及实验室确诊病例诊断标准判定完全正确的分别为3、0和8人。全部临床医生均能准确回答布病诊断后应于24 h内进行报告。结论 山西省布病疫情重点地区医疗机构对该病诊断的准确性不高，临床医生对于该病的诊断及其分类标准基础知识熟悉、掌握程度不够。 |
| English Abstract: |
| Objective To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0% (127/165) and 66.0% (140/212) respectively, the differences had significance (χ2=5.4, P=0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1% (256/294) and 13.3% (11/83) respectively, and the differences had significance (χ2=170.7, P<0.001). Among the 21 investigated clinical doctors, the numbers of the doctors who correctly diagnosed the suspected cases, probable cases and lab-confirmed cases were only 3, 0 and 8 respectively. All of the clinical doctors knew that it is necessary to report the brucellosis cases within 24 hours after diagnosis. Conclusion The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied. |
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