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目的评价山东省乙型病毒性肝炎(乙肝)病例监测点监测信息质量,为完善乙肝病例监测系统提供参考。方法随机抽取部分山东省2013年8个乙肝病例监测点(县、市、区,下同)报告病例,计算关键信息报告完整率;通过电话回访和现场调查对监测报告的关键信息进行复核,计算信息一致率;比较复核前后急、慢性乙肝分类情况,评价报告信息质量对临床分类的影响。结果是否首次被诊断为乙肝、首次检出乙肝病毒表面抗原(Hepatitis B Virus Surface Antigen,HBs Ag)阳性时间、肝炎相关临床症状与体征、丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)四项关键变量报告完整率分别为99.70%、78.71%、99.35%和86.16%,其中首次检出HBs Ag阳性时间和肝炎相关临床症状与体征的完整率随时间逐渐升高,各季度差异有统计学意义(P<0.01、P=0.03);电话复核各关键变量的一致率分别为73.91%(187/253)、77.08%(195/253)、58.50%(148/253)、88.14%(223/253),现场复核各关键变量一致率分别为93.18%(41/44)、90.91%(40/44)、75%(33/44)和77.27%(34/44);电话复核前后急性和慢性乙肝分类一致率分别为54.54%(6/11)和96.49%(165/171),各型分类总体一致率为93.10%(216/232),总体一致性最佳(Kappa值=0.83);现场复核前后急性和慢性乙肝分类一致率分别为85.71%(6/7)和81.25%(26/32),各型分类总体一致率为84.09%(37/44),总体一致性显著(Kappa值=0.69)。结论山东省乙肝病例监测点部分监测信息质量有待提高,监测信息的真实性影响了急性乙肝的正确分类。
Objective To evaluate the quality of monitoring information of surveillance points of hepatitis B cases in Shandong Province and provide reference for improving the monitoring system of hepatitis B cases. Methods A total of eight hepatitis B case surveillance sites (counties, cities, districts and the same below) in Shandong province were randomly selected from Shandong Province in 2013 to calculate the completeness rate of key information reports. The key information of monitoring reports was reviewed by telephone interview and on-site survey to calculate Information consistency rate; before and after review of acute and chronic hepatitis B classification, evaluation report information quality impact on clinical classification. The first time was diagnosed as hepatitis B, the first detection of hepatitis B virus surface antigen (HBsAg) positive time, the clinical symptoms and signs of hepatitis, Alanine aminotransferase (Alanine Aminotransferase ALT) four key The complete rate of variable reporting was 99.70%, 78.71%, 99.35% and 86.16% respectively. The positive rate of HBsAg positive for hepatitis C for the first time and the completeness of the clinical symptoms and signs related to hepatitis increased gradually over time, with significant differences in each quarter P <0.01, P = 0.03). The concordance rates of the key variables of telephone review were 73.91% (187/253), 77.08% (195/253), 58.50% (148/253), 88.14% , And the consistency rates of the key variables in on-site review were 93.18% (41/44), 90.91% (40/44), 75% (33/44) and 77.27% (34/44) respectively. The rates of acute and chronic hepatitis B The consistency rate was 54.54% (6/11) and 96.49% (165/171), respectively. The overall agreement rate was 93.10% (216/232) in all categories, and the overall consistency was the best (Kappa = 0.83) The concordance rates of acute and chronic hepatitis B were 85.71% (6/7) and 81.25% (26/32), respectively. The overall agreement rate of all types was 84.09% (37/44) Significantly (the Kappa value = 0.69). Conclusion The monitoring information quality of some hepatitis B cases in Shandong Province needs to be improved. The authenticity of the monitoring information affects the correct classification of acute hepatitis B.