慢性阻塞性肺疾病疗效评价结局指标权重专家问卷调查研究

Experts’ questionnaires survey on COPD therapeutic evaluation outcome indexes weight

目的:明确慢性阻塞性肺疾病(COPD)疗效评价指标体系中各指标的权重大小。方法:基于文献研究结果,制定COPD疗效评价专家调查问卷,遴选呼吸领域有影响的专家50名,采用信函法进行调查,回收问卷建立数据库,运用德尔菲法进行评价,采用均数和满分率评价专家意见集中程度,采用变异系数和协调系数评价专家意见协调程度,采用百分权重法对各结局指标进行赋权。结果:发放问卷50份,回收50份,专家积极系数为100.0%,专家意见协调系数为0.719,卡方检验差异具有统计学意义(P<0.001),根据权重系数大小各结局指标排序为急性加重次数(0.188)、肺功能1s用力呼气容积(FEV1)(0.187)、症状积分(0.151)、生活质量积分(0.147)、6min步行距离(6MWD)(0.137)、呼吸困难指数(MMRC)(0.096)和医疗费用(0.093)。结论:基于专家问卷构建了COPD疗效评价指标体系,包括急性加重次数、肺功能FEV1、症状积分、生活质量积分、6MWD、MMRC和医疗费用,其中急性加重次数和肺功能的权重最大,MMRC和医疗费用的权重较小,丰富和完善了COPD疗效评价指标体系框架。

Objective： To definite the weight coefficient for each index with COPD therapeutic evaluation index system. Methods： Based on the research results from the literature research, the experts survey questionnaire of COPD therapeutic evaluation was established. 50 senior technical titles experts from respiration field were selected to survey by letter method. The database was established after questionnaires recoveried applying the Delphi method to evaluate. The expert opinions concentrate degree was evaluated by mean and full mark rate. The expert opinions coordinate degree was evaluated by coefficient of variability and coordination coefficient. The indexs weight was determined with the percent weight method. Results： The study probided 50 experts survey questionnaires in total and reclaimed 50 questionnaires. The expert positive coefficient was 100.0%. The expert opinion cooperation index was 0.719 and there were statistical differences by chi-square test （Z2=215.642, P〈0.001）. The indexs sequence was AECOPD times （0.188）, pulmonary function FEV1 （0.187）, signs and symptoms scores （0.151）, QOL scores （0.147）, six-minutes walk distance （6MWD） （0.137）, ModifiedMedical Research Council Scale （MMRC） （0.096） and Medical expenses （0.093） according to weight coefficient. Conclusion： The COPD therapeutic evaluation index system included the AECOPD times, pulmonary function FEV1, signs and symptoms scores, QOL scores, 6MWD, MMRC and Medical expenses based on the experts＇ questionnaires survey. The weight coefficient of the AECOPD times and pulmonary function FEV1 were higer while the weight coefficient of MMRC and Medical expenses were less. The research perfected the COPD therapeutic evaluation indexs system framework.