血清硫酸黏多糖片段和肿瘤相关物质群检测诊断非小细胞肺癌的价值

目的研究血清硫酸黏多糖片段(SGF)和肿瘤相关物质群(TSGF)联合检测诊断非小细胞肺癌(NSCLC)的应用价值。方法采用胶乳凝集法和生化比色法,联合检测NSCLC组及各对照组血清SGF和TSGF水平。结果血清SGF和TSGF并联诊断NSCLC患者敏感度、特异度、阳性预测值(PPV)、阳性似然比(+LR)、阴性似然比(-LR)和准确度分别为95.3%,87.8%,55.5%,7.81,0.054和78.9%,串联诊断NSCLC患者各值分别为84.4%,98.9%,96.4%,76.7,0.158和94.7%。结论血清SGF和TSGF联合检测对协助诊断和鉴别诊断NSCLC有十分重要的应用价值。     

简阳市地中海贫血筛查试验评价

目的对四川省简阳市地贫筛查试验进行分析与评价,为地贫筛查流程的优化提供科学依据。方法对简阳市2014-10/2018-12接受地贫基因检测的168人的筛查数据进行分析,采用灵敏度、特异度和似然比等评价指标。运用SPSS 22.0软件进行统计分析,灵敏度和特异度的比较采用χ~2检验,绘制各指标的ROC曲线并计算AUC。结果MCV、MCH、HbA2和HbF 4项指标的灵敏度分别为88.07%、91.74%、88.07%和14.68%,特异度分别为83.05%、77.97%、38.98%和84.75%,阳性似然比分别为5.20、4.16、1.44和0.96,阴性似然比分别为0.14、0.11、0.31和1.01。HbF的灵敏度低于其他指标(χ~2=117.520,130.004,117.520,P0.01),HbA2的特异度低于其他指标(χ~2=24.085,18.463,26.186,P0.01)。血常规检查、血红蛋白分析、串联试验和并联试验四项筛查试验的灵敏度分别为92.66%、88.99%、99.08%和82.57%,特异度分别为76.27%、25.42%、18.64%和83.05%,阳性似然比分别为3.90、1.19、1.22和4.87,阴性似然比分别为0.10、0.43、0.05和0.21。夫妇筛查方案3(双方血常规检查阳性且至少一方血红蛋白分析阳性)的灵敏度(84.62%)和特异度(86.67%)均较高。MCV、MCH、HbA2(筛查α地贫)、HbA2(筛查β地贫)和HbF的AUC分别为0.895、0.901、0.608、0.970、和0.700,HbA2对β地贫的筛查价值最高。MCV、MCH、HbA2(筛查α地贫)、HbA2(筛查β地贫)和HbF的最佳截断值分别为77.50 fl、24.85 pg、2.75%、3.88%和0.75%。结论 MCV、MCH和HbA2具有较高的筛查价值,目前简阳市地贫筛查试验的特异度较低,误诊的可能性大,地贫筛查流程亟待优化。     

全自动酶免方法检测登革病毒抗原抗体的有效性评价

目的评价全自动酶联免疫吸附(ELISA)实验方法在献血人群中检测登革病毒NS1抗原和Ig M、Ig G抗体的有效性。方法以疾病预防控制中心常规使用的登革病毒NS1抗原和Ig M、Ig G抗体的实验诊断方法作为参照,对全自动ELISA方法的检测结果进行评价。结果全自动ELISA方法检测NS1的灵敏度、特异度、约登指数、阳性预测值、阴性预测值、符合率和Kappa值分别为96.11%、94.81%、0.91、92.51%、97.34%、95.33%和0.903,检测Ig M的灵敏度、特异度、约登指数、阳性预测值、阴性预测值、符合率和Kappa值分别为97.04%、91.11%、0.88、91.61%、96.85%、94.07%和0.881,检测Ig G的灵敏度、特异度、约登指数、阳性预测值、阴性预测值、符合率和Kappa值分别为92.96%、90.00%、0.83、90.29%、92.75%、91.48%和0.830。结论全自动ELISA检测方法检测结果可靠,适用于大规模献血人群的登革病毒感染筛查。     

优势比在诊断试验评价中的应用

诊断试验是辅助临床医师进行疾病诊断的试验方法，评价诊断试验准确度的常用指标，包括灵敏度（真阳性率，TPR）、特异度（真阴性率，TNR）、假阴性率（FNR）、假阳性率（FPR）、约登指数、似然比（LR）、阳性预测值（PPV）、阴性预测值（NPV）等。这些指标各有优缺点。其实，可以利用流行病学中的优势比（OR）概念，将其应用到诊断试验的评价中，与传统的指标相比，OR在某些方面有其独特的优势和用途，为此拟对诊断试验OR的含义及应用做一介绍。     

实时荧光定量PCR在预防性健康体检沙门菌快速筛查中的应用效果

目的探讨real-time PCR在从业人员沙门菌快速筛查中的应用效果。方法采集从业人员肛拭子样本,分别用real-time PCR方法及分离培养法对沙门菌进行检测,并比较检测结果。结果以分离培养法为金标准,real-time PCR进行筛检试验,结果灵敏度为100.0%,特异度为98.1%,阳性似然比为51.63,阴性似然比为0,符合率为98.2%,Kappa值为0.87,阳性预测值为78.1%,阴性预测值为100.0%。从成本效益分析来看,real-time PCR虽在检测成本上略高于分离培养法,但可节省大量的人力,缩短健康证办证时间,提高办证效率。结论 real-time PCR方法结果判读客观性强,且灵敏度高、特异性强,省时省力,可用于从业人员沙门菌的快速筛查中。     

研究国产TB-IGRA试剂盒在涂片阴性肺结核诊断中的应用

目的探讨国产TB-IGRA试剂盒在痰涂片阴性肺结核诊断中的应用价值。方法用北京万泰生物药业股份有限公司生产的TB-IGRA试剂盒,分别检测229例痰涂片阴性和33例痰涂片阳性肺结核病患者、50例其他肺部疾病患者和50例健康对照者结核感染情况,并与英国Oxford Immunotec公司生产的T-SPOT-TB试剂盒比较检测的灵敏度、特异度、准确度及阴性似然比和阳性似然比。结果 TB-IGRA检测痰涂片阴性和阳性肺结核患者的阳性检出率分别为90.0%和93.9%,两者之间差异无统计学意义(χ2值为0.53,P0.05)。TB-IGRA和T-SPOT-TB检测结核的灵敏度分别为90.5%和89.7%,特异度分别为86.0%和82.0%,2种试剂盒的灵敏度和特异度差异无统计学意义(χ2值分别为0.1、0.6,P0.05)。TB-IGRA方法的准确度、阳性和阴性预测值、阳性似然比均高于T-SPOT-TB,阴性似然比低于T-SPOT-TB。结论 TB-IGRA检测痰涂片阴性肺结核具有快速和较高的灵敏度和特异度,值得临床推广应用。     

γ-干扰素释放试验诊断结核分枝杆菌感染的研究

目的探讨γ-干扰素(IFN-γ)释放试验(IGRA)在结核分枝杆菌(MTB)感染中的诊断价值。方法利用原核系统表达的MTB融合蛋EC和CM,应用EC-IGRA和CM-IGRA检测131例MTB感染者和120名健康人,通过工作特征曲线(ROC曲线)分析两种方法诊断MTB感染者的临界值、灵敏度、特异度、阳性预测值(PPV)和阴性预测值(NPV)。结果 EC-IGRA和CM-IGRA诊断MTB感染的临界值分别是352.2 pg/ml和393.4 pg/ml,灵敏度分别是79.4%和76.3%,特异度分别是98.3%和100%,PPV分别是98.1%和100%,NPV分别是81.3%和79.4%。两种方法联合(即ECIGRA阳性或CM-IGRA阳性,该个体即为MTB感染者)的灵敏度(95.4%)和NPV(95.1%)显著高于单方法 (P0.001),而特异度(98.3%)和PPV(98.4%)与单方法相比保持不变(P0.05)。结论 EC-IGRA和CM-IGRA联合诊断MTB感染具有较好的诊断价值,应用前景良好。     

线性探针技术在四川地区结核分枝杆菌耐药检测中的应用评价

目的评估线性探针技术(LPA)在四川地区结核分枝杆菌耐药检测中的应用价值。方法对2014-04收集的297例分枝杆菌分离培养物进行传统比例法药敏实验和线性探针检测,分析线性探针技术检测结核分枝杆菌对利福平、异烟肼耐药性及MDR-TB的灵敏度、特异性、阳性预测值、阴性预测值、一致性及Kappa值。结果以传统比例法药敏为金标准,线性探针技术检测利福平耐药情况的灵敏度为90.00%,特异度为96.08%,阳性预测值为78.26%,阴性预测值为98.39%,一致性为95.25%,Kappa值为0.81;检测异烟肼耐药情况的灵敏度为85.00%,特异度为97.87%,阳性预测值为91.07%,阴性预测值为96.23%,一致性为95.25%,Kappa值为0.85;检测MDR-TB的灵敏度为88.46%,特异度为97.40%,阳性预测值为76.67%,阴性预测值为98.87%,一致性为96.61%,Kappa值为0.80。利福平耐药菌株中,rpoB主要突变位点为531、526和516,异烟肼耐药菌株的主要突变位点为katG S315T1。结论线性探针技术能够快速准确的检测利福平、异烟肼的药物敏感性,有利于耐多药结核病的快速筛查和诊断。在基层应用时应加强管理和人员培训。     

血生化指标联合超声标记预测胎儿染色体异常价值探讨

目的探讨血生化指标联合超声标记预测胎儿21-三体综合征、18-三体综合征的价值。方法收集在首都医科大学附属北京妇产医院接受孕中期(20～24+6周)产前超声检查且染色体结果为21-三体(28例)、18-三体(17例)或染色体判定为正常(5 572例)的共计5 617例病例的超声影像学信息及唐氏筛查(血清学三联产前筛查)结果,通过计算灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比、约登指数、受试者工作特征曲线(ROC曲线)下面积(AUC)等指标,分析比较唐氏筛查结果单独预测染色体异常与唐氏筛查结合超声信息联合预测染色体异常两种筛查方法的效果。结果接受唐氏筛查共计4 122例,检查率为73. 4%。唐氏筛查结合超声信息联合预测染色体异常的特异度(83. 4%)低于唐氏筛查结果单独预测染色体异常的特异度(93. 1%),但灵敏度及综合性指标(约登指数、AUC)高于唐氏筛查结果单独预测染色体异常的对应指标(联合判定效果:灵敏度84. 2%、约登指数67. 6%,AUC 0. 838;唐氏筛查效果:灵敏度42. 1%,约登指数35. 2%,AUC 0. 535)。结论血清学三联产前筛查(唐氏筛查)诊断胎儿染色体异常存在一定的局限,联合应用孕中期产前超声检查指标可以在一定程度上改善诊断效果。     

X线钼靶与超声诊断乳腺疑似病变价值比较

目的 评价并比较X线钼靶和乳腺超声用于乳腺疑似病变的诊断效能。方法 以经X线钼靶或乳腺超声诊断的80例女性疑似乳腺病变患者作为研究对象,以组织病理学检测结果作为金标准,计算并比较X线钼靶和乳腺超声检测乳腺病变的灵敏度、特异度、阳性预测值（PPV）、阴性预测值（NPV）及准确度。结果 80例疑似女性乳腺病变患者中,经组织病理学检查确诊乳腺癌57例、乳腺良性病变23例。X线钼靶诊断疑似女性乳腺病变灵敏度、特异度、NPV、PPV和准确度分别为63.16%、73.91%、44.74%、85.71%和66.25%,乳腺超声诊断疑似女性乳腺病变灵敏度、特异度、NPV、PPV和准确度分别为78.95%、21.74%、29.41%、71.43%和62.50%。X线钼靶和乳腺超声诊断疑似女性乳腺病变灵敏度（χ² = 3.45,P > 0.05）、NPV（χ² = 1.15,P > 0.05）、PPV（χ² = 2.92,P > 0.05）、准确度（χ² = 0.25,P > 0.05）差异均无统计学意义,但两者检测特异度差异有统计学意义（χ² = 12.55,P < 0.01）。结论 X线钼靶和乳腺超声用于疑似女性乳腺病变诊断准确度类似,但X线钼靶诊断疑似女性乳腺病变特异度明显高于乳腺超声。     

成人血尿酸对代谢综合征的筛检能力研究

目的 检验血尿酸浓度对代谢综合征的诊断能力，分析血尿酸水平对福建省居民代谢综合征的影响。方法 采用随机抽样的方法在福建省10个县调查收集6 134名居民体检和实验室检测资料，分析血尿酸水平对代谢综合征的筛检能力，及血尿酸对代谢综合征的影响。结果 福建省人群男女代谢综合征患病率分别为19.00%和12.70%，含有代谢综合征组份越多的人群，尿酸水平越高，男性尿酸水平筛检代谢综合征的临界值为412.95 μmol/L，受试者工作特征曲线下面积、灵敏度、特异度、阳性预测值、阴性预测值分别为0.635、51.02%、59.74%、28.34%和85.86%；女性人群中血尿酸浓度>310.30 μmol/L时，曲线下面积为0.674，灵敏度、特异度、阳性预测值、阴性预测值分别为63.33%、63.04%、19.35%和92.20%。经过校正年龄和居住地后，男、女性高血尿酸组患代谢综合征的危险度分别是低血尿酸组2.571（2.116~3.124）和2.806（2.249~3.502）倍。结论 通过血尿酸诊断代谢综合征的有一定的临床意义，高血尿酸是代谢综合征及其组份的危险因素。     

Self-report of high cholesterol: determinants of validity in U.S. adults

BACKGROUND: Hypercholesterolemia is a major cardiovascular risk factor, and cholesterol awareness is important in both clinical practice and in public health. We evaluated the validity of self-reported hypercholesterolemia and identified determinants of validity. METHODS: The study design was a cross-sectional survey, from 1988 to 1994, of adult participants (N=8236) from the Third National Health and Nutrition Examination Survey for whom self-report of hypercholesterolemia and serum measurement were available. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for self-reported hypercholesterolemia were calculated using total cholesterol > or =5.17 mmol/L (200 mg/dL) and/or taking cholesterol-lowering medication as the criterion standard. RESULTS: Overall test characteristics for self-report were sensitivity, 51%; specificity, 89%; PPV, 87%; and NPV, 55%. Sensitivity of self-report was higher among older subjects and non-Hispanic whites, specificity was higher among subjects with >12 years of education, PPV was higher in older subjects, and NPV was higher in younger subjects and in those with >12 years of education. Using higher cholesterol thresholds to define hypercholesterolemia led to higher sensitivity, lower specificity, lower PPV, and higher NPV. Sociodemographic and anthropometric predictors of validity were identified by logistic regression. CONCLUSIONS: Due to low sensitivity, self-reported hypercholesterolemia should be used with caution, both during the patient encounter and for surveillance of trends in hypercholesterolemia in the absence of measured cholesterol levels. Specificity is consistently much higher than sensitivity. The high PPV may be of use in certain clinical situations. Such validation studies should form the foundation for future research based on self-report.     

心肌损伤标志物检测在诊断病毒性心肌炎中的价值

摘要:目的　探讨联合检测心肌损伤标志物对心肌炎患儿心肌损伤的诊断价值。方法　对64例病毒性心肌炎（VMC）患儿、56例非病毒性心肌炎（NVMC）患儿和52名健康对照儿童,分别检测2种心肌损伤标志物心肌肌钙蛋白I（cTn I）、肌酸激酶同工酶（CK-MB）和5种心肌酶活性。结果　检测cTn I 和CK-MB诊断心肌炎敏感性分别为71.88%和68.75%,差异无统计学意义（χ2＝0.15,P＝0.70）;特异性分别为96.30%和65.74%,差异有统计学意义（χ2＝32.78,P＜0.001）;准确性分别为87.21%和66.86%,差异有统计学意义（χ2＝20.13,P＜0.001）。检测cTn I 和CK-MB对心肌炎诊断指数分别为0.68和0.34;阳性预告值分别为92.00%和54.32%,差异有统计学意义（χ2＝20.41,P＜0.001）;阴性预告值分别为85.25%和78.02%,差异无统计学意义（χ2＝1.86,P＝0.17）;联合检测cTn I 与CK-MB诊断心肌炎敏感性为84.38%、特异性为100%、准确性为94.19%、诊断指数为0.84、阳性预告值为93.10%、阴性预告值为91.22%。结论　联合检测cTn I与CK-MB诊断VMC的敏感性、特异性、准确性、阳性预告值与阴性预告值,均高于单一检测,对诊断病毒性心肌炎效果更好。     

Validity of self-reported influenza and pneumococcal vaccination status among a cohort of hospitalized elderly inpatients

Use of self-reported vaccination status is commonplace in assessing vaccination coverage for public health programs and individuals, yet limited validity data exist. We compared self-report with provider records for pneumococcal (23vPPV) and influenza vaccine for 4887 subjects aged>or=65 years from two Australian hospitals. Self-reported influenza vaccination status had high sensitivity (98%), positive predictive value (PPV) (88%) and negative predictive value (NPV) (91%), but low specificity (56%). Self-reported 23vPPV (previous 5 years) had a sensitivity of 84%, specificity 77%, PPV 85% and NPV 76%. Clinicians can be reasonably confident of self-reported influenza vaccine status, and for positive self-report for 23vPPV in this setting. For program evaluation, self-reported influenza vaccination coverage among inpatients overestimates true coverage by about 10% versus 1% for 23vPPV. Self-report remains imperfect and whole-of-life immunisation registers a preferable goal.     

高危型人乳头瘤病毒检测对细胞学结果为意义不明的非典型鳞状细胞和低度鳞状上皮内病变的管理价值

目的 探讨第二代杂交捕获试验(Hc-2)检测高危型人乳头瘤病毒(HR-HPV)DNA对细胞学结果为意义不明的非典型鳞状细胞(ASCUS)和低度鳞状上皮内病变(LSIL)的管理价值.方法 收集细胞学结果为ASCUS(178例)和LSIL(108例)的HR-HPV感染情况,以敏感度、特异度、阳性预测值和阴性预测值来评价Hc-2检测HR-HPV DNA在宫颈病变筛查中的价值.结果 Hc-2检测HR-HPV DNA对于ASCUS中病理结果为宫颈上皮内瘤变(CIN)Ⅱ及其以上级别病变的敏感度为89.83%(53/59),特异度为53.78%(64/119),阳性预测值为49 07%(53/108),阴性预测值为91.43%(64/70):对于LSIL中CIN Ⅱ及其以上级别病变的敏感度为97.62%(41/42),特异度为22.73%(15/66),阳性预测值为44.57%(41/92),阴性预测值为93.75%(15/16).结论 HR-HPV DNA检测是一种管理细胞学结果为 ASCUS和LSIL病例的有效手段.

Abstract：

Objective To discuss the significance of high-risk human papilloma virus ( HR-HPV) detection by hybrid capture 2 (Hc-2) in managing the women with atypical squamous cell of undetermined significance (ASCIIS) and low grade squamous intraepithelial lesion (LSIL) of thin prep liquid-based cytology (TCT). Methods One hundred and seventy-eight women with ASCUS and 108 women with LSIL were studied. The infection of HR-HPV in the women was analyzed. And sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were used to evaluate the significance of HR-HPV detection by Hc-2 in managing the women with ASCUS and LSIL of TCT. Results Sensitivity,specificity, PPV and NPV of HR-HPV DNA detection by Hc-2 in screening CIN II or above in ASCUS were 89.83% (53/59),53.78% (64/119), 49.07% (53/108), 91.43% (64/70) respectively,and in LSIL were 97.62%(41/42),22.73%(15/66), 44.57%(41/92), 93.75%( 15/16) respectively. Conclusion HR-HPV detection by Hc-2 is an effective measure in managing the women with ASCUS and LSIL of TCT.     

Estimating sensitivity and specificity from positive predictive value, negative predictive value and prevalence: application to surveillance systems for hospital-acquired infections

Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) are terms usually associated with diagnostic testing. Although these concepts have been expanded from diagnostic assays to surveillance systems, these systems are not like diagnostic assays. In attempting to estimate the sensitivity and specificity of surveillance systems, situations may arise where only the PPV, NPV and prevalence are known. We aim to demonstrate the equivalence of two methods for calculating sensitivity and specificity from PPV, NPV and prevalence. The formulae for sensitivity and specificity are calculated from first principles and compared with the adjustment of a standard contingency table. We have illustrated this method using a review of a sample of surgical site infection cases following coronary artery bypass grafting. The derived prevalence from the sample is an estimate of the population prevalence and is the value that must be used in the formulae for sensitivity and specificity as functions of PPV, NPV and prevalence to obtain the same estimates as those obtained from the adjusted contingency table. The general proof of this principle is provided as an Appendix. The sensitivity and specificity of surveillance systems can be calculated by two equivalent methods when only PPV, NPV and prevalence are known.     

Designation of children with high blood pressure--considerations on percentile cut points and subsequent high blood pressure: the Bogalusa Heart Study

The effects of changing the percentile cut points of prior blood pressure measurements (both single and serial examinations) on prediction of subsequent high blood pressure, and of the definition of subsequent high blood pressure were assessed in 1,501 children from Bogalusa, Louisiana. Subjects were 2-14 years old at initial examination (year 1, 1973-1974) and were reexamined three, five, and eight years after the initial examination. Increasing the stringency of the prior measurement cut point resulted in increased specificity and positive predictive value, but decreased sensitivity and negative predictive value. For prediction of subsequent systolic blood pressure at the 90th percentile from year 1 levels, increasing the year 1 cut point from the 80th to the 95th percentile resulted in decreased sensitivity from 42.8 to 13.0%, and increased specificity from 83.0 to 97.3%. For systolic pressure, requiring all prior serial measurements to be above specified cut points resulted in further increases in specificity (maximizing at 100%) and decreases in sensitivity (minimizing at 2.1%). Using a year 1 cut point at the 90th percentile, increases in the definition of subsequent high blood pressure (from the 80th percentile to 140/90 mmHg or on treatment, respectively) resulted in increased sensitivity (from 20.5 to 33.3%) and negative predictive value, with decreasing specificity (from 93.9 to 91.3%) and positive predictive value. The results indicate that use of stringent criteria (serially at the 95th percentile) to identify children at risk for future essential hypertension will result in a substantial portion of the childhood population who will escape early identification but who will develop adult hypertension. Less stringent criteria will increase sensitivity and thereby provide the opportunity for primary prevention to a larger portion of the general childhood population who are at high risk for adult hypertension.     

夜间最低血氧饱和度联合睡眠相关量表筛查儿童阻塞性睡眠呼吸暂停的应用

目的 评价夜间最低血氧饱和度(LSaO₂)联合OSA-18量表和针对儿童的改良版Epworth嗜睡量表(ESS-CHAD)初筛儿童阻塞性睡眠呼吸暂停(OSA)的准确性,以探讨更简便、快捷、可行的基层医院初筛疑似儿童OSA的方法。方法 纳入2020年8月13日—2021年2月8日就诊于本院耳鼻咽喉头颈外科睡眠监测中心完成整夜多导睡眠监测的儿童139例作回顾性分析研究,其家长在医生协助下完成OSA-18量表和ESS-CHAD。分析LSaO₂和两种量表及三者联合早期初筛疑似儿童OSA的诊断价值。结果 LSaO₂预测儿童是否患OSA的最佳界值为90.5%(P<0.00, AUC=0.82)。OSA-18和ESS-CHAD依据不同界值分别诊断儿童OSA的灵敏度最高,分别为74.8%、22.7%。LSaO₂/OSA-18,LSaO₂/ESS-CHAD、OSA-18/ESS-CHAD诊断儿童OSA的灵敏度最高,分别为88.2%、68.1%、77.3%。 结论 LSaO₂有诊断儿童OSA的临床价值,OSA-18量表较ESS-CHAD初筛疑似儿童OSA有更高的灵敏度,但特异度低,LSaO₂联合OSA-18量表诊断儿童OSA的灵敏度、特异度均较其他联合诊断方式高。在无法进行睡眠监测的基层医院可考虑应用LSaO₂ 与OSA-18量表结合的方式初步筛查儿童OSA。     

Name analysis to classify populations by ethnicity in public health: validation of Onomap in Scotland

Objectives

Health inequalities between ethnic minorities and the general population are persistent. Addressing them is hampered by the inability to classify individuals’ ethnicity accurately. This is addressed by a new name-based ethnicity classification methodology called ‘Onomap’. This paper evaluates the diagnostic accuracy of Onomap in identifying population groups by ethnicity, and discusses applications to public health practice.

Study design

Onomap was applied to three independent reference datasets (birth registration, pupil census and register of Polish health professionals) collected in Britain and Poland at individual level (n = 260,748).

Methods

Results were compared with the reference database ethnicity ‘gold standard’. Outcome measures included sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Ninety-five percent confidence intervals and Chi-squared tests were used.

Results

Onomap identified the majority of those in the British participant group with high sensitivity and PPV (>95%), and low misclassification (<5%), although specificity and NPV were lowest in this group (56–87%). Outcome measures for all other non-British groupings were high for specificity and NPV (>98%), but variable for sensitivity and PPV (17–89%). Differences in misclassification by gender were statistically significant. Using maiden name rather than married name in women improved classification outcomes for those born in the British Isles (0.53%, 95% confidence interval 0.26–0.8%; P < 0.001) but not for South Asian or Polish groups.

Conclusions

Onomap offers an effective methodology for identifying population groups in both health-related and educational datasets, categorizing populations into a variety of ethnic groups. This evaluation suggests that it can successfully assist health researchers, planners and policy makers in identifying and addressing health inequalities.     

抗心磷脂抗体、血β-HCG、平均动脉压联合预测 妊娠期高血压疾病的意义

目的:探讨孕中期血抗心磷脂抗体(ACA)、β-人绒毛膜促性腺激素(β-HCG)、平均动脉压联合预测妊娠期高血压疾病的意义。方法:选择自2008年12月～2010年1月孕妇198例,采用酶联免疫吸附法测定血ACA,放射免疫方法测定血β-HCG值,同时测量平均动脉压,对检测结果进行统计学分析。结果:妊娠期高血压疾病孕妇在孕15～20周β-HCG值明显高于正常妊娠者,差异有统计学意义(P<0.05)。以血β-HCG值>50 371 IU/L,CAC阳性,平均动脉压≥85 mmHg为联合预测指标,阳性预测值为89.66%,阴性预测值95.35%,敏感度80.76%,特异度97.04%。结论:孕中期联合检测血β-HCG值、ACA和平均动脉压有较高的敏感性和特异性。