摘要
目的了解目前中国梅毒报告病例数据的质量,发现存在的问题,提出改进措施。方法 2013年6-11月,根据中国地区分布选择5个省份的10个地市、13个县区的43家医疗机构,由专业人员按国家方案和诊断标准对报告的梅毒病例信息质量和诊断质量进行现场调查与评价,包括核查原始报卡、临床与实验室记录;使用Excel2003和SPSS 18.0软件进行统计分析。结果 5个省份梅毒病例的报告及时率、报卡填写完整率、填写正确率、网络录入正确率,分别为99.82%(1691/1694)、97.05%(1644/1694)、96.22%(1630/1694)和96.22%(1 630/1694);重复报卡率很低,为1.42%(24/1694)。对5个省份2611例梅毒病例的诊断质量进行评价,梅毒病例诊断正确率达95.40%(2491/2611);但一期、二期和隐性梅毒临床分期正确率分别为42.49%(167/393)、77.46%(275/355)和85.89%(1497/1743),存在较为严重的错误分类偏倚,即部分非皮肤性病科、住院部医生将隐性梅毒病例错误地分为一期或二期梅毒。结论 5个省份调查的梅毒病例报告信息质量与诊断正确率较高,但一期和二期梅毒分期正确率较低,影响梅毒发病率的分析,迫切需要加强梅毒诊断标准的培训,切实提高病例数据的质量。
Objective To assess the data quality of syphilis cases reported in China, and identify the problems for improving the quality. Methods According to the national protocol and syphilis diagnostic criteria, checking data with original reporting cards, clinical and laboratory logs of syphilis cases were collected, assessment of diagnosis correctness were conducted by related experts at 43 medical hospitals/institutions, sampled in 13 counties of 10 prefectures in 5 provinces based on geographic distribution to evaluate the data quality, and Excel 2003 and SPSS18.0 software were employed in data analysis. Results The proportions of the reporting cards timely reported, completely filled, correctly filled, correctly entered by web for syphilis cases were as high as with 99.82% （1691/1694）, 97.05% （1644/1694）, 96.22% （1630/1694） and 96.22% （1630/1694）, respectively, and the one of the reporting cards repeatedly reported was very low with 1.42%（24/1694） in 5 provinces. The proportions of correct diagnosis for syphilis cases was high with 95.40% （2491/2611）, however, the ones of correct stage for pri- mary, secondary and latent syphilis were not high with 42.49% （167/393）, 77.46% （275/355） and 85.89% （1497/1743）, respectively. There was the severe bias of misclassification in primary and secondary syphilis, the reason of which was that some latent syphilis cases were falsely classified into primary and secondary ones by non dermatological/STD and in-patients department doctors. Conclusion The indicators of data quality related to reporting information and correct diagnosis of syphilis cases were high, however proportion of correct stage for primary and secondary syphilis cases was low, which directly affected on analysis of syphilis incidence. It is urged that the training on related doctors in syphilis diagnosis criteria should be strengthened to substantially improve the data quality.
出处
《中国艾滋病性病》
CAS
北大核心
2015年第4期314-317,共4页
Chinese Journal of Aids & STD
