武汉市武昌区手足口病控制图法预警模型研究

Study on alarming model based on control chart method for hand,foot and mouth disease in Wuchang District of Wuhan City

目的基于控制图法构建武汉市武昌区手足口病预警模型,确定最佳预警界值,为该区手足口病监测工作提供数据支持。方法从国家传染病报告系统中整理2009-2014年武昌区手足口病数据并建立数据库,采用移动百分位数法建立预警模型,通过筛检试验方法对模型进行评价,计算出灵敏度、特异度、阳性预测值和阴性预测值,绘制ROC曲线并找出最佳预警界值。结果武汉市武昌区手足口病最佳预警界值为P90,其灵敏度、特异度、阳性预测值和阴性预测值分别为75.00%、93.88%、50.00%和97.87%。结论手足口病预警界值的确定应根据发病特点结合当地疫情优选,注重地区特异性,提高传染病疫情监测能力。

Objective To establish the early warning model based on the control chart method for hand, foot and mouth disease （HFMD） in Wuchang District and to determine the optimum alarming threshold to provide the data support for HFMD monitoring work. Methods The data of HFMD in Wuchang District during 2009--2014 were collected from the National Infectious Diseases Notification System for constructing the data base. The mobile percentile method was adopted to establish the early alarming model,which was evaluated by the screening test. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. Then the receiver operating characteristic （ROC） curve was drawn and the optimum alarming threshold was found out. Results The early alarming threshold of HFMD in Wuchang District was P90, its sensitivity, specificity, positive predictive value and negative predictive value were 75.00%, 93.88 %, 50.00 % and 97.87%, respectively, Conclusion Determining the early Warning threshold should be optimized according to onset characteristics combining with the local epidemic situation, which pays attention to regional specificity and increases the monitoring ability of infectious diseases.