CT诊断的准确率,以确定COVID-19患者的住院需求
- 作者: Morozov S.1, Reshetnikov R.1,2, Gombolevskiy V.1, Ledikhova N.1, Blokhin I.1, Mokienko O.1
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隶属关系:
- Moscow Center for Diagnostics and Telemedicine
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
- 期: 卷 2, 编号 1 (2021)
- 页面: 5-16
- 栏目: 原创性科研成果
- URL: https://journals.rcsi.science/DD/article/view/46818
- DOI: https://doi.org/10.17816/DD46818
- ID: 46818
如何引用文章
详细
论证:在俄罗斯联邦,为了检测COVID-19肺炎及其并发症和与其他肺部疾病的鉴别诊断,以及对患者进行分类,使用了胸部CT,并在CT 0–4的半定量视觉尺度上评估变化。尽管胸部CT广泛使用,但其用于确定COVID-19患者住院需求的诊断准确性的数字指标目前尚不清楚。
目的: 是确定该量表的敏感性、特异性、阳性预测值、阴性预测值。
材料与方法:研究涉及575名经实验室确诊的COVID-19患者(55%为女性),年龄为57.2±13.9岁。对于每个患者,进行了4次连续的胸部CT研究,并对疾病的严重程度进行了CT评分(0–4)。根据既往CT研究结果,将敏感性和特异性作为患者病情恶化或改善的条件概率进行计算。为计算阳性预测值(PPV)和阴性预测值(NPV),对COVID-19在莫斯科的流行情况进行了估计。2020年3月6日至11月28日期间所有COVID-19病例的数据来自俄国国家管理的保护消费者服务机构(Rospotrebnadzor)网站。使用了许多具有不同参数的ARIMA和EST模型来选择与现有数据最匹配的模型,并预测发病率的发展。
结果:0–4 CT分级的中位特异性为69%,敏感性为92%。描述莫斯科流行病学情况的最佳统计模型是ARIMA(0,2,1)。经计算,预测年发病率为9.6%,PPV值为56,NPV值为97%。
结果:Yuden指数最大的阶段出现在胸部CT第一次研究和第二次研究之间,此时样本中大多数患者表现出临床病情恶化的趋势。0–4 CT分级可以安全地排除轻、中度病程(CT0、CT1类)患者的病理变化发展,有助于优化患者在疫情不利的情况下住院。
作者简介
Sergey Morozov
Moscow Center for Diagnostics and Telemedicine
Email: morozov@npcmr.ru
ORCID iD: 0000-0001-6545-6170
SPIN 代码: 8542-1720
MD, Dr.Sci. (Med), Professor
俄罗斯联邦, MoscowRoman Reshetnikov
Moscow Center for Diagnostics and Telemedicine; I.M. Sechenov First Moscow State Medical University (Sechenov University)
编辑信件的主要联系方式.
Email: reshetnikov@fbb.msu.ru
ORCID iD: 0000-0002-9661-0254
SPIN 代码: 8592-0558
Cand.Sci. (Phys-Math)
俄罗斯联邦, MoscowVictor Gombolevskiy
Moscow Center for Diagnostics and Telemedicine
Email: gombolevskiy@npcmr.ru
ORCID iD: 0000-0003-1816-1315
SPIN 代码: 6810-3279
MD, Cand.Sci. (Med)
俄罗斯联邦, MoscowNatalya Ledikhova
Moscow Center for Diagnostics and Telemedicine
Email: n.ledikhova@npcmr.ru
SPIN 代码: 6907-5936
俄罗斯联邦, Moscow
Ivan Blokhin
Moscow Center for Diagnostics and Telemedicine
Email: i.blokhin@npcmr.ru
ORCID iD: 0000-0002-2681-9378
SPIN 代码: 3306-1387
俄罗斯联邦, Moscow
Olesya Mokienko
Moscow Center for Diagnostics and Telemedicine
Email: o.mokienko@npcmr.ru
ORCID iD: 0000-0002-7826-5135
SPIN 代码: 8088-9921
MD, Cand.Sci. (Med)
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