PICC相关性静脉血栓风险评估量表的编制及信效度检验

Development and validation of the risk assessment tool for PICC-related thrombosis

目的构建PICC相关性静脉血栓风险评估量表,并检验其信效度。方法结合国内外相关文献,构建PICC相关性静脉血栓风险评估量表条目池;通过专家咨询法、层次分析法,形成PICC相关性静脉血栓风险评估初始量表,采用该量表对130例患者进行血栓风险评估,以验证该量表的信度、效度;描绘受试者操作特征曲线,找出最佳高危临界值及其对应的识别能力。结果 PICC相关性静脉血栓风险评估量表包括3个维度和22个条目;量表的3个维度和总量表的Cronbach’s α系数分别为0.805、0.683、0.751、0.794;受试者操作特征曲线结果显示,曲线下面积为0.728[P=0.013,95%CI(0.594, 0.862)],最佳高危临界值为5.5,其对应的灵敏度为0.909,特异度为0.471。结论本研究构建的PICC相关性静脉血栓风险评估量表具有良好的信效度,可以作为临床工作中筛查PICC置管患者静脉血栓风险的评估工具。

Objective To construct and validate a tool for risk assessment of PICC associated venous thrombosis to provide scientific basis for rapidly improving recognition rate of PICC-related thrombosis.Methods Combining with relevant literature,item pool of risk assessment tool for PICC-related thrombosis was established. By Delphi Method and analytic hierarchy process (AHP),the risk assessment index system of PICC-related thrombosis was established. A total of 130 cancer patients were investigated to test reliability and validity. ROC curve was constructed to identify the critical value and corresponding recognition capacity.Results The risk assessment index system of PICC-related thrombosis included 3 first-level indicators,and 22 second-level indicators. The Cronbach’s alpha of three dimensions,as well as the whole scale were 0.805,0.683,0.751,and 0.794 respectively. The results of ROC curve showed that AUC was 0.728 [P=0.013,95%CI(0.594,0.862)],The best high-risk critical value was 5.5,while corresponding sensitivity was 0.909,and specificity was 0.471.Conclusion The PICC-related venous thrombosis risk assessment scale has good reliability and validity,which can be used as an assessment tool for screening risks of venous thrombosis in PICC patients during clinical practice.