冠心病痰湿证临床诊断标准诊断效能评价与阈值修订

Diagnostic Efficacy Evaluation and Threshold Revision of Clinical Diagnostic Criteria for Phlegm-dampness Syndrome of Coronary Heart Disease

目的:评价冠心病痰湿证临床诊断标准的诊断效能并修订诊断阈值,为临床实践提供诊断依据。方法:采用诊断性试验研究方法,通过计算敏感度、特异度、准确度等评价冠心病痰湿证临床诊断标准的诊断效能,同时绘制受试者工作特征曲线(receiver operator characteristic curve,ROC),根据约登指数获取最佳诊断阈值。结果:冠心病痰湿证临床诊断标准ROC曲线下面积为0.835,95%置信区间为0.724~0.946。根据约登指数最大值(0.62)将诊断阈值修订为“≥5分”后,该标准的敏感度、特异度和准确度分别为90%、72%和86.4%。结论:调整诊断阈值后的冠心病痰湿证临床诊断标准反映出更好的诊断效能。

Objective:To evaluate the diagnostic efficacy of the clinical diagnostic criteria of phlegm-dampness syndrome with coronary heart disease,revise the diagnostic threshold,and provide diagnostic basis for clinical practice.Methods:The diagnostic test method is used to evaluate the diagnostic efficacy of the criteria by calculating sensitivity,specificity and accuracy.At the same time,the Receiver Operator Characteristic Curve(ROC)is drawn,and the best diagnostic threshold is obtained according to Youden index.Results:The area under the ROC curve of the diagnostic criteria is 0.835,95%confidence interval is 0.724~0.946.After the diagnostic threshold is revised to"≥5 points"according to the maximum value of Youden index(0.62),the sensitivity,specificity and accuracy of the criteria are 90%,72%and 86.4%,respectively.Conclusion:The clinical diagnostic criteria of phlegm-dampness syndrome with coronary heart disease reflects better diagnostic efficiency after adjusting the diagnostic threshold.