鱼骨图法对寄生虫病血清学调查质量效果评价

Evaluation of quality control of seroepidemiological survey on five parasitic diseases by fish-bone chart method

目的控制全国人体重要寄生虫病现状调查血清检测的质量,为进一步提高质控水平和检测效率积累经验。方法采用鱼骨图法对5种寄生虫病血清流行病学调查质量控制进行评价。结果分析调查可能产生的质量问题,找出干预措施,通过抽样复测部分血清样品,用符合率与Kappa值分析2次检测的一致程度。通过对5种寄生虫病血清样品复测,确定5种寄生虫病血样2次检测观察一致率,囊虫病、包虫病、并殖吸虫病、旋毛虫病和弓形虫病分别为98.85%,97.47%,97.21%,92.84%和98.14%。囊虫病Kappa值为0.73,重现性好,后4种寄生虫病Kappa值依次为0.94,0.86,0.77和0.87,重现性极好。对5种寄生虫病血清样品2次检测的Kappa值进行显著性检验,u值均>2.58,P<0.01,表明这5种病Kappa值因机遇所致的可能性很小。结论采用鱼骨图法对5种寄生虫病血清流行病学调查质量控制效果较理想。

Objective To control the quality of seroepidemiological survey in the national survey of current situation of major human parasitic diseases in China and accumulate experiences for further improving the quality control level and efficiency in serological tests for future investigations. Methods Fish - bone chart method was used to study on control the quality for this survey. Results To analyse the possible quality problems by fish - bone chart method then adopt intervention measures to solve these problems. Some serum samples were reexamined through sampling, and the agreement of the two tests was analyzed by using coincidence rate and Kappa value to evaluate the effect of the quality control of this survey. Through reexamination of the serum samples of 5 parasitic diseases, it was found that the overall coincidence rate of the two tests on the serum samples of 5 parasitic diseases were 98.85 %, 97.47 %, 97.21%, 92.84 % and 98.14 % respectively for cysticercosis, hydatidosis, paragonimiasis, trichinellosis and toxoplasmosis. The Kappa value of cysticercosis was 0.73 with good repro- ducibility, and the Kappa value for the other 4 parasitic diseases was respectively 0.94, 0.86, 0.77 and 0.87, indicating that all the serum samples of the 4 parasitic diseases had very good reproducibility. Significance test on the Kappa values of the two tests on the serum samples of 5 parasitic diseases was calculated, u values were all≥2.58, P 〈 0.01, indicating that the Kappa value of these 5 parasitic diseases was not accidental. Conclusion It could be considered that the quality control for this seroepidemiological survey of 5 parasitic diseases was relatively ideal by fish - bone chart method.