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目的对广东省传染病自动预警系统(CIDARS)在预警阈值调整前后不同地区、病种的预警效能进行评价,为系统的改进提供依据。方法对预警阈值调整前后广东省21个地市调整了预警阈值的13种传染病的报告病例数、预警信号数、阳性预测值、错误预警率和重复预警率进行评价。结果 13种病种预警信号数与当前大疫情系统报告病例数在阈值调整前后均呈正相关(r分别为0.929和0.934,P<0.01),各地市的预警信号数与其报告病例数在阈值调整前后也均呈正相关(r分别为0.917和0.845,P<0.01)。阈值调整前后,全省阳性预测值分别为0.91%和0.89%,有19个地市较调整前有不同程度的上升;全省错误预警率分别为97.37%和99.44%,有14个地市较调整前有不同程度的下降,其中痢疾、腹泻病、流感、结膜炎、伤寒、乙脑、甲肝和戊肝有超过一半以上的地市下降;全省重复预警率分别为58.41%和40.18%,有20个地市较调整前有不同程度的下降。结论预警阈值调整后,广东省大部分地区、病种的预警效能有明显提高,由于个别地区、病种的发病特点存在差异,因此系统仍需进一步优化和完善。
Objective To evaluate the early-warning effectiveness of CIDARS in Guangdong Province before and after the warning threshold adjustment in different areas and diseases, and provide the basis for the improvement of the system. Methods The number of reported cases, the number of early warning signals, the positive predictive value, the false early warning rate and the repeated early warning rate of 13 infectious diseases with warning threshold adjusted in 21 cities of Guangdong Province before and after the warning threshold adjustment were evaluated. Results The number of early warning signals of 13 kinds of diseases was positively correlated with the number of reported cases in the current large epidemic situation system before and after the threshold adjustment (r = 0.929 and 0.934, respectively, P <0.01). The number of early warning signals and the number of reported cases before and after the threshold adjustment Also had a positive correlation (r = 0.917 and 0.845 respectively, P <0.01). Before and after the threshold adjustment, the positive predictive value of the province was 0.91% and 0.89% respectively, with 19 prefectures increasing in varying degrees compared with that before the adjustment; the false warning rates in the province were 97.37% and 99.44% respectively, with 14 prefectures and cities Before the adjustment, there were different degrees of decline. Diarrhea, diarrhea, flu, conjunctivitis, typhoid fever, Japanese encephalitis, hepatitis A and E had more than half of the prefectures and cities. The repeat warning rate in the province was 58.41% and 40.18% respectively, There are 20 cities before the adjustment of varying degrees of decline. Conclusion After the pre-warning threshold adjustment, the early-warning efficacy of the disease in most parts of Guangdong Province has obviously increased. Because of the differences in the incidence characteristics of the disease in some areas, the system still needs to be further optimized and improved.