广东省传染病自动预警系统预警效能评价

目的对广东省传染病自动预警系统(CIDARS)在预警阈值调整前后不同地区、病种的预警效能进行评价,为系统的改进提供依据。方法对预警阈值调整前后广东省21个地市调整了预警阈值的13种传染病的报告病例数、预警信号数、阳性预测值、错误预警率和重复预警率进行评价。结果 13种病种预警信号数与当前大疫情系统报告病例数在阈值调整前后均呈正相关(r分别为0.929和0.934,P0.01),各地市的预警信号数与其报告病例数在阈值调整前后也均呈正相关(r分别为0.917和0.845,P0.01)。阈值调整前后,全省阳性预测值分别为0.91%和0.89%,有19个地市较调整前有不同程度的上升;全省错误预警率分别为97.37%和99.44%,有14个地市较调整前有不同程度的下降,其中痢疾、腹泻病、流感、结膜炎、伤寒、乙脑、甲肝和戊肝有超过一半以上的地市下降;全省重复预警率分别为58.41%和40.18%,有20个地市较调整前有不同程度的下降。结论预警阈值调整后,广东省大部分地区、病种的预警效能有明显提高,由于个别地区、病种的发病特点存在差异,因此系统仍需进一步优化和完善。

Evaluation on efficiency of China infectious disease automated-alter and response system of Guangdong province

Objective Through evaluating the efficacy before and after the warning threshold adjustment of China Infectious Disease Automated-alter and Response System （CIDARS） in different areas and for different diseases,to provide scientific basis for system improvement. Method The reported number of cases, positive rates of early-warning signals, error rate and repeated warning rates of 13 infectious diseases in 21 cities of Guangdong province before and after the warning threshold adjustment were evaluated. Results The warning signal number of 13 diseases had positive correlation with the reported number of cases in the epidemic surveillance system both before and after the warning threshold adjustment （r was 0.929 and 0.934, P〈0.001 ）, as well as seen in different cities （r was 0.917 and 0.845,P〈 0.001）.The overall positive predictive value of early-warning signals in Guangdong province were 0.91% and 0.89% before and after the adjustment of warning threshold,respectively,with the positive predictive value increased in 19 cities. The overall error rate were 97.37% and 99.44% before and after the adjustment of warning threshold, respectively, with the error early-warning rate decreased in 14 cities; in more than half of prefectural cities, the error warning rates for dysentery, diarrhea, influenza, conjunctivitis, typhoid fever, Japanese encephalitis, hepatitis A and hepatitis E had decreased; the overall repeated warning rates were 58.41% and 40.18% before and after the adjustment in Guangdong province, respectively, with the different decline seen in 20 cities. Condusion Although the efficacy of various warning related diseases of CIDARS had been improved through threshold adjustment in most cities,some functions and parameters need to be further adjusted due to the different areas and diseases.