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目的 评价临床诊断方法对基础训练期间新兵应力性骨折的诊断效能。方法 以同位素骨扫描为金标准 ,对 2 88例可疑应力性骨折患者临床诊断方法的真实性和可靠性指标进行评价。结果 按病例计算时 ,敏感度、特异度、准确度、阳性预告值、阴性预告值、阳性似然比、阴性似然比和Youden指数分别为 97.5 %、6 1.7%、91.7%、92 .9%、82 .9%、2 .5 5、0 .0 4和 0 .5 9。两名医师临床诊断的符合率为 81.7% ,kappa值0 .6 4;当以受伤部位数计算时 ,上述真实性指标分别为 97.2 %、84.1%、89 .7%、82 .0 %、97.6 %、6 .12、0 .0 3和 0 .81,两名医师临床诊断的符合率为 94.4% ,kappa值0 .88。结论 临床诊断方法用于诊断新兵基础训练期间应力性骨折具有较高的诊断效能和良好的符合率。
Objective To evaluate the diagnostic efficacy of clinical diagnostic methods for recruits stress fractures during basic training. Methods The isotope bone scan was used as the gold standard to evaluate the authenticity and reliability of clinical diagnosis of 2 88 patients with suspected stress fracture. Results The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and Youden index were 97.5%, 67.1%, 91.7% and 92.9 respectively %, 82.9%, 2.55,0.0.04 and 0.59. The coincidence rate of the two doctors in clinical diagnosis was 81.7% and kappa value was 0.646. The above-mentioned authenticity indexes were 97.2%, 84.1%, 89.7%, 82.0% and 97.6 %, 6.12,0. 03 and 0 .81 respectively. The coincidence rates of the two doctors in clinical diagnosis were 94.4% and kappa values were 0.88. Conclusion Clinical diagnosis method is used to diagnose the stress fracture of recruits during basic training with high diagnostic efficiency and good coincidence rate.