摘要
目的采用DisMod校正法判断天津市2007—2015年发病监测系统中急性心肌梗死(AMI)发病报告的完整性。方法收集天津市2007—2015年发病监测数据和死因登记数据中的AMI发病率和死亡率及健康测量评估研究所公布的AMI缓解率,应用DisModⅡ模型估算校正后的AMI死亡发病比(M/I),对DisMod法和直接法计算的M/I值进行差异性检验,并根据DisMod法估算的发病率估计现有发病检测系统的漏报率。结果天津市2007—2015年AMI的M/I值经DisMod法校正后为0.49~0.97,均<1;在≥65岁人群中,直接法计算AMI的M/I值均较DisMod法计算的M/I值大,差异均有统计学意义(均P<0.05);DisMod法校正估算的总发病数与原始发病数比较,平均每年DisMod法校正估算的发病数(11837例)大于原始发病数(8563例),尤其在≥65岁人群;按照DisMod法校正发病死亡的关系后,发病监测系统每年的平均漏报率在26.4%,≥65岁人群平均漏报率为42.9%。结论天津市AMI发病监测系统可能存在一定漏报,尤其是≥65岁人群,可采用DisMod校正法来判断AMI发病/患病监测系统的完整性。
Objective To evaluate the completeness of acute myocardial infarction(AMI)incidence reports in Chronic Disease Incidence Surveillance System(CDISS)of Tianjin between 2007 and 2015 using DisModⅡ(DisMod stands for DISease MODelling,a software developed by World Health Organization).Methods We extracted the data on AMI incidence and mortality among residents in Tianjin between 2007 and 2015 from CDISS and Death Registry System;we also collected data on remission rate for AMI patients in Tianjin published by Institute of Health Metrics and Evaluation.Then we calculated mortality/incidence ratios(M/I)by original data and DisModⅡ.The difference of M/I values between the above two methods were tested,and then underreporting rate of AMI incidence in CDISS was estimated.Results The DisMod-adjusted M/I values of AMI were all less than 1(ranging from 0.49 to 0.97)during the period.The directly calculated M/I values for the population aged≥65 years were significantly greater than the DisMod-adjusted M/I values(all P<0.05).Compared to the reported average annual number of AMI incidence(8 563),a greater average annual number(11 837)of AMI incidence was estimated by DisMod calculation,especially for the number of AMI incidents aged 65 years and above.The estimated average annual underreporting rate of CDISS was 26.4%for all AMI incidents and the rate was 42.9%for the AMI incidents aged 65 years and above.Conclusion There may be some underreporting AMI incidents in CDISS of Tianjin,especially for those aged 65 years and above and calculations with DisMod software could be used to evaluated the completeness of AMI disease surveillance system.
作者
阎月明
刘阳
江国虹
汪德征
张辉
沈成凤
张颖
万霞
YAN Yue-ming;LIU Yang;JIANG Guo-hong(Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences/School of Basic Medicine,Peking Union Medical College/Peking Union Medical College & Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100005,China)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2019年第7期861-865,共5页
Chinese Journal of Public Health
基金
中华医学基金会(15–208)
中国医学科学院医学与健康科技创新工程(2016–I2M–3–001)
