新兵基础训练期间应力性骨折的临床诊断评价

A diagnosis test of stress fracture during basic training set for new military recruits

目的 评价临床诊断方法对基础训练期间新兵应力性骨折的诊断效能。方法 以同位素骨扫描为金标准 ,对 2 88例可疑应力性骨折患者临床诊断方法的真实性和可靠性指标进行评价。结果 按病例计算时 ,敏感度、特异度、准确度、阳性预告值、阴性预告值、阳性似然比、阴性似然比和Youden指数分别为 97.5 %、6 1.7%、91.7%、92 .9%、82 .9%、2 .5 5、0 .0 4和 0 .5 9。两名医师临床诊断的符合率为 81.7% ,kappa值0 .6 4;当以受伤部位数计算时 ,上述真实性指标分别为 97.2 %、84.1%、89 .7%、82 .0 %、97.6 %、6 .12、0 .0 3和 0 .81,两名医师临床诊断的符合率为 94.4% ,kappa值0 .88。结论 临床诊断方法用于诊断新兵基础训练期间应力性骨折具有较高的诊断效能和良好的符合率。

Objective To evaluate efficacy of stress fracture (SF) during basic training for military recruits using clinical diagnosis method. Methods Two hundred and eighty eight suspected SF were checked clinically and with bone scanning as golden standard. Results Sensitivity, specificity, accuracy, positive and negative predictive value, positive and negative likelihood ratios and Youden's index of clinical diagnosis were found to be 97.5 %, 61.7 %, 91.7 %, 92.9 %, 82.9 %, 2.55 , 0.04 and 0.59 respectively when calculated with cases. The agreement rate between two physicians was 81.7 % with kappa value 0.64 . When calculated with position, the precious measures were 97.2 %, 84.1 %, 89.7 %, 82.0 %, 97.6 %, 6.12 , 0.03 , and 0.81 respectively. The agreement rate between two physicians was 94.4 % with kappa value 0.88 . Conclusion Efficacy reliability and agreement of clinical diagnosis for SF seemed to be satisfactory.