运用德尔菲法构建三种疾病发病风险指数的探讨

Discussion on construction of three disease risk indexes by Delphi method

目的构建马鞍山市流行性感冒(简称"流感")、手足口病、其他感染性腹泻病的风险指数模型,为疾病预测预警提供科学依据。方法采用德尔菲法(Delphi)确定疾病风险指数模型中的指标并计算各指标权重系数,建立流感、手足口病、其他感染性腹泻病风险指数的计算公式,各指标数据根据指标评分表转换为分值进入公式计算得出风险指数,再将风险指数参照风险等级判别规则,得出相应的风险等级。结果第一轮专家积极系数为100%,第二轮专家积极系数为89.5%。两轮咨询专家的权威系数均在0.70以上。专家两轮咨询协调系数差异均有统计学意义(P<0.05)。流感风险指数模型:Y=0.250×X1+0.270×X2+0.240×X3+0.083×X41+0.079×X42+0.078×X43;手足口病风险指数模型:Y=0.130×X1+0.130×X2+0.320×X3+0.143×X41+0.139×X42+0.138×X43;其他感染性腹泻病风险指数模型:Y=0.330×X1+0.330×X2+0.114×X31+0.114×X32+0.112×X33,并将近三年数据回代模型预测,与实际数据比较,一致率均在70%以上。结论马鞍山市三种疾病风险指数模型的建立,能够将数据通过简单的模型较好地转化为风险等级,能够发挥疾病发病风险提示作用。

Objective To construct the risk index models of influenza,hand-foot-mouth disease(HFMD)and other infectious diarrhea in Ma’anshan City,and to provide scientific basis for disease prediction and early warning.Methods Delphi method was used to determine the indexes in the disease risk index model and calculate the weight coefficients of each index.The calculation formulas of the risk indexes of influenza,hand-foot-mouth disease and other infectious diarrhea diseases were established.The risk indexes were calculated by converting each index data into scores according to the index scoring table,and then the risk indexes were calculated by referring to the risk level discrimination rules to get the corresponding risk level.Results The expert positive coefficient of the first round was 100%,and that of the second round was 89.5%.The authority coefficient of the two rounds of consultation experts was above 0.70.Coordination coefficients of the two rounds of consultation between experts were statistically significant(P<0.05).Influenza risk index model:Y=0.250×X1+0.270×X2+0.240×X3+0.083×X41+0.079×X42+0.078×X43;HFMD risk index model:Y=0.130×X1+0.130×X2+0.320×X3+0.143×X41+0.139×X42+0.138×X43;other infectious diarrhea risk index model:Y=0.330×X1+0.330×X2+0.114×X31+0.114×X32+0.112×X33.Compared with the actual data,the consistency rate of the model prediction was more than 70%.Conclusion The establishment of three disease risk index models in Ma’anshan City could transform the data into risk level through simple models,and play a role of disease risk indication.