当前位置: X-MOL 学术Pediatr. Allergy Immunol. Pulmonol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Perception of Pulmonary Function in Children with Asthma and Cystic Fibrosis.
Pediatric Allergy, Immunology, and Pulmonology ( IF 0.9 ) Pub Date : 2018-10-05 , DOI: 10.1089/ped.2018.0906
Erick Forno 1, 2 , Neethu Abraham 1 , Daniel G Winger 3 , Christian Rosas-Salazar 4 , Geoffrey Kurland 1, 2 , Daniel J Weiner 1, 2
Affiliation  

Background: Under-perception of pulmonary dysfunction may delay appropriate treatment, while over-perception may result in unnecessary treatments. Objectives: To evaluate the ability of patients with asthma or cystic fibrosis and their subspecialty caregivers to assess changes in lung function based on their subjective clinical impressions. Methods: Patients were asked to qualitatively describe how they felt compared to their prior visit (same/better/worse) and to quantitatively estimate their forced expiratory volume in 1 s (FEV1) after being reminded of their FEV1 at the prior visit. Providers made similar estimates based on history and physical examination and knowledge of prior FEV1. After adjusting for relevant clinical covariates, lung function estimates were categorized as accurate (±5% of measured FEV1), overestimated (>5% above measured), and underestimated (>5% below measured). Results: One hundred nine patients estimated FEV1 on 179 occasions. Concordance between patient qualitative assessment and FEV1-based categories was low (κ = 0.08); 44% of patients reported feeling better than the FEV1-based category showed. Quantitatively, 56% of patient estimates were accurate, 18% were underestimated, and 26% overestimated; accuracy improved with age (odds ratio = 1.16, P = 0.01). Concordance between provider qualitative assessments and FEV1-based category was moderate (κ = 0.35); about 19% said their patient looked better than the FEV1-based category showed. Quantitatively, 65% of provider estimates were accurate, 16% were underestimated, and 19% were overestimated; accuracy improved with years of experience. Conclusions: Patients' and providers' perceptions of lung function were low to moderately accurate. Relying on subjective impression may place patients at risk for unnecessary treatments or increased morbidity. These findings highlight the importance of objective lung function assessment.

中文翻译:

哮喘和囊性纤维化患儿对肺功能的感知。

背景:对肺功能不全的感知不足可能会延迟适当的治疗,而过度感知可能会导致不必要的治疗。目的:评估哮喘或囊性纤维化患者及其专科护理人员根据其主观临床印象评估肺功能变化的能力。方法:要求患者定性描述与前次就诊相比(相同/更好/更差)的感觉,并定量估计前一次就诊时的FEV1后1秒内的强迫呼气量(FEV1)。提供商根据历史和体格检查以及先前的FEV1知识做出类似的估算。在调整了相关的临床协变量之后,将肺功能评估分为准确的(测量的FEV1的±5%),过高的评估(> 高于测量值5%)和低估(低于测量值5%)。结果:179例患者中有179次评估了FEV1。患者定性评估与基于FEV1的类别之间的一致性较低(κ= 0.08);44%的患者报告感觉好于基于FEV1的类别。从数量上看,有56%的患者估计是准确的,有18%被低估了,而26%被高估了;精度随着年龄的增长而提高(赔率= 1.16,P = 0.01)。提供者定性评估与基于FEV1的类别之间的一致性为中等(κ= 0.35);约19%的患者表示他们的患者看起来比基于FEV1的患者更好。从数量上讲,提供者估计的准确度为65%,被低估了16%,被高估了19%;多年的经验提高了准确性。结论:患者和提供者的 对肺功能的认识低至中等准确。依靠主观印象可能会使患者处于不必要治疗或增加发病率的风险中。这些发现突出了客观肺功能评估的重要性。
更新日期:2019-11-01
down
wechat
bug