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Weighted Youden index and its two-independent-sample comparison based on weighted sensitivity and specificity

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Chinese Medical Journal 2013年第6期126卷 1150-1154页

作者： LI Dan-ling SHEN Frank YIN Yue PENG Jun-xiang chen ping-yan Department of Biostatistics School of Public Health and Tropical Medicine Southern Medical University Guangzhou Guangdong 510515 China Shanghai Roche Pharmaceuticals Ltd. Roche ProductDevelopment in Asia Pacific Shanghai 201203 China

Background Most indices for evaluating a diagnostic test can be expressed as functions of sensitivity （SEN） and specificity （SPE）. Practically, all existing methods suffer from the inability to weight sensitivity and specificity relative to their importance. In this paper, we developed a novel index, the weighted Youden index, that allows Youden index to be a combination of sensitivity and specificity with user-defined weights. Methods The weighted Youden index Jw is defined as Jw=2（wxSEN＋（1-w）SPE）-I （0 〈w 〈1）. It has three properties：（1） the sum of the weights which are attached to sensitivity and specificity should be equal to 1; （2） the range of Jw should be within [-1, 1], which is the range of the Youden index J; （3） Jw should be equal to J when sensitivity and specificity have equal weights. According to the central limit theorem, we obtain the standard error of Jw, and propose a statistical inference method to compare two weighted Youden indices. The monotonicity of the test statistic was discussed. Results An example of comparing two diagnostic tests for pheochromocytoma was used to demonstrate the weighted Youden index method. Weighted Youden index, the confidence interval for each test and the hypothesis test of comparing two independent diagnostic tests were presented. Assigning the weights is essential to the weighted Youden index approach. Conclusion The weighted Youden index can broaden further research in weighting sensitivity and specificity exp ts applications in diagnostic test development and motivate icitly.

关键词： Youden index diagnostic tests weights sensitivity specificity

Impact of Heat Wave in 2005 on Mortality in Guangzhou, China

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Biomedical and Environmental Sciences 2013年第8期26卷 647-654页

作者： yanG Jun LIU Hua Zhang OU Chun Quan LIN Guo Zhen DING yan ZHOU Qin SHEN Ji Chuan chen ping yan Department of Biostatistics School of Public Health and Tropical Medicine Southern Medical University Guangzhou Center for Disease Control and Prevention Faculty of Medicine Southern Medical University

Objective To assess the impact of the heat wave in 2005 on mortality among the residents in Guangzhou and to identify susceptible subpopulations in Guangzhou, China. Methods The data of daily number of deaths and meteorological measures from 2003 to 2006 in Guangzhou were used in this study. Heat wave was defined as 〉7 consecutive days with daily maximum temperature above 35.0 ~C and daily mean temperature above the 97th percentile during the study period. The excess deaths and rate ratio （RR） of mortality in the case period compared with the reference period in the same summer were calculated. Results During the study period, only one heat wave in 2005 was identified and the total number of excess deaths was 145 with an average of 12 deaths per day. The effect of the heat wave on non-accidental mortality （RR=l.23, 95% CI： 1.11-1.37） was found with statistically significant difference. Also, greater effects were observed for cardiovascular mortality （RR=l.34, 95% Cl： 1.13-1.59） and respiratory mortality （RR=I.31, 95% CI： 1.02-1.69）. Females, the elderly and people with lower socioeconomic status were at significantly higher risk of heat wave-associated mortality. Conclusion The 2005 heat wave had a substantial impact on mortality among the residents in Guangzhou, particularly among some susceptible subpopulations. The findings from the present study may provide scientific evidences to develop relevant public health policies and prevention measures aimed at reduction of preventable mortality from heat waves.

关键词： Heat wave Mortality Temperature China

The Impact of Relative Humidity and Atmospheric Pressure on Mortality in Guangzhou, China

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Biomedical and Environmental Sciences 2014年第12期27卷 917-925页

作者： OU Chun Quan yanG Jun OU Qiao Qun LIU Hua Zhang LIN Guo Zhen chen ping yan QIAN Jun GUO Yu Ming State Key Laboratory of Organ Failure Research Department of Biostatistics School of Public Health and Tropical Medicine Southern Medical University National Institute for Communicable Disease Control and Prevention Chinese Center for Disease Control and Prevention Guangzhou First People's Hospital Guangzhou Medical University Guangzhou Center for Disease Control and Prevention Department of Mathematics and Physics School of Biomedical Engineering Southern Medical University Department of Epidemiology and Biostatistics School of Population Health The University of Queensland

Objective Although many studies have examined the effects of ambient temperatures on mortality, little evidence is on health impacts of atmospheric pressure and relative humidity. This study aimed to assess the impacts of atmospheric pressure and relative humidity on mortality in Guangzhou, China. Methods This study included 213,737 registered deaths during 2003-2011 in Guangzhou, China. A quasi-Poisson regression with a distributed lag non-linear model was used to assess the effects of atmospheric pressure/relative humidity. Results We found significant effect of low atmospheric pressure/relative humidity on mortality. There was a 1.79% （95% confidence interval： 0.38%-3.22%） increase in non-accidental mortality and a 2.27% （0.07%-4.51%） increase in cardiovascular mortality comparing the 5th and 25th percentile of atmospheric pressure. A 3.97% （0.67%-7.39%） increase in cardiovascular mortality was also observed comparing the 5th and 25th percentile of relative humidity. Women were more vulnerable to decrease in atmospheric pressure and relative humidity than men. Age and education attainment were also potential effect modifiers. Furthermore, low atmospheric pressure and relative humidity increased temperature-related mortality. Conclusion Both low atmospheric pressure and relative humidity are important risk factors of mortality. Our findings would be helpful to develop health risk assessment and climate policy interventions that would better protect vulnerable subgroups of the population.

关键词： Relative humidity Atmospheric pressure Temperature Mortality

以假性Bartter综合征为主要表现的囊性纤维化患儿3例并文献复习

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中国当代儿科杂志 2024年第5期26卷 506-511页

作者：张继燕孙林军段效军张子敏肖政辉陈艳萍游洁玉湖南省儿童医院呼吸内科湖南长沙410001 湖南科技职业学院药学院湖南长沙410004 湖南省儿童医院儿研所湖南长沙410001 湖南省儿童医院急救中心湖南长沙410001 湖南省儿童医院消化内科湖南长沙410001

目的总结以假性Bartter综合征(pseudo-Bartter syndrome,PBS)为主要表现的囊性纤维化(cystic fibrosis,CF)(CF-PBS)患儿的临床特征和基因变异,以提高对CF-PBS的认识。方法回顾性分析2018年1月—2023年8月在湖南省儿童医院确诊的3例CF-PBS患儿的临床资料并文献复习。结果3例患儿均在婴儿期起病,入院后检验示低钠、低钾、低氯血症和代谢性碱中毒,基因检测示CFTR基因存在复合杂合变异,均诊断为CF。文献检索33例CF-PBS中国患儿,起病年龄和诊断年龄分别为1~36月龄、3~144月龄,伴有反复呼吸道感染或持续肺炎29例(88%)、营养不良26例(79%)、发育落后23例(70%)、胰腺炎或可疑胰腺外分泌功能不全18例(55%);c.2909G>A是CFTR基因最常见的变异位点,等位基因变异频率为23%(15/66)。结论CF早期无典型的呼吸道症状,对于反复出现的低钠、低钾、低氯血症和代谢性碱中毒的婴儿,特别是同时存在营养不良、发育落后,需警惕CF-PBS可能,应尽早进行CFTR基因检测协助诊断CF。

关键词：囊性纤维化假性Bartter综合征 CFTR基因儿童

Current pattern of Chinese dialysis units： a cohort study in a representative sample of units

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Chinese Medical Journal 2012年第19期125卷 3434-3439页

作者： ZHOU Qiu-gen JIANG Jian-ping WU Sheng-jie TIAN Jian-wei chen Jiang-hua YU Xue-qing chen ping-yan MEI Chang-lin XIONG Fei SHI Wei ZHOU Wei LIU Xu-sheng SUN Shi-ren XIE Di LIU Jun XU Xin HOU Fan-fan Division of Nephrology Nanfang Hospital Southern Medical University Key Lab for Organ Failure Research Ministry of Education Guangzhou Guangdong 510515 China Division of Nephrology the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang 310003 China Division of Nephrology the First Affiliated Hospital Sun Yat-sen University Guangzhou Guangdong 510080 China Department of Biostatistics Southern Medical University Guangzhou Guangdong 510515 China Division of Nephrology Changzheng Hospital secondary Military Medical University Shanghai 200003 China Division of Nephrology the First People's Hospital Wuhan Hubei 430060 China Division of Nephrology Guangdong General Hospital Guangzhou Guangdong 510080 China Division of Nephrology the 309th Hospital of People's Liberation Army Beijing 100091 China Division of Nephrology Guangdong Provincial Hospital of Traditional Chinese Medicine Guangzhou Guangdong 510080 China Division of Nephrology Xijing Hospital Fourth Military Medical University Xi'an Shaanxi 710032 China

Background Understanding the characteristics of Chinese dialysis patients and the current practice trends is the first step to evaluate the association between practice pattern and outcome in these populations. In the present study, we evaluated the status of medical treatment and characteristic features of chronic dialysis patients in China. Methods Through a clustering sampling, we selected 9 centers from the largest dialysis facilities in 6 cities around China. All adult undergoing dialysis in the selected units were screened. A total of 2388 （1775 on hemodialysis （HD） and 613 on peritoneal dialysis （PD）） patients were finally enrolled. All data were collected at enrollment on the bases of review of medical records. Results In this cohort, 1313 （55.0%） were male. The mean age was 54 years old. The median time for dialysis was 26 months （12-51 months）. Seventy-five percent of patients were on HD and 25.0% on PD. Among PD patients, about 21% patients did not receive dialysis adequacy. For HD patients, about 14.0% of them did not achieve dialysis adequacy when the target of kt/V was set as 1.2. Only 44.7% of patients achieved blood pressure target of 140/90 mmHg. About 60% of patients did not reach the hemoglobin target of 110 g/L even though 85.0% of them were treated with erythropoietin. In addition, 48.5% of the patients had uncontrolled mineral metabolism revealed by the high calcium-phosphate product. Compared with HD patients, higher level of serum glucose, triglyceride, and total and low density lipoprotein cholesterol were more common in PD patients. Conclusions This observational study suggests that many Chinese dialysis patients did not achieve the therapeutic target, particularly in blood pressure control, anemia correction, and mineral balance. PD patients were more likely to suffer metabolic disturbance.

关键词： chronic dialysis practice pattern outcome China

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青少年生命敬畏感问卷的编制及信效度检验

中国临床心理学杂志 2024年第3期32卷 575-581页

作者：林荣茂沈逸琳林可心陈艳萍谢涵颖何晓雁熊夏昕福建师范大学心理学院福州350117 赣南师范大学新闻与传播学院赣州341000 荷兰格罗宁根大学社会心理学系荷兰9712 TS 福州工商学院福州350715 福建技术师范学院教育学院福清350300

目的:编制青少年生命敬畏感问卷并检验其信效度。方法:通过访谈并结合国内已有的相关测量工具编制初始问卷,以187名青少年为被试对问卷进行项目分析和探索性因素分析,以1000名青少年为被试对问卷进行验证性因素分析和信效度检验,最终得... 详细信息

目的:编制青少年生命敬畏感问卷并检验其信效度。方法:通过访谈并结合国内已有的相关测量工具编制初始问卷,以187名青少年为被试对问卷进行项目分析和探索性因素分析,以1000名青少年为被试对问卷进行验证性因素分析和信效度检验,最终得到正式问卷。结果:青少年生命敬畏感正式问卷共12个项目,包括生命敬重感、死亡畏惧感及生命意义超越3个维度。总问卷Cronbach’sα系数为0.78,合成信度为0.90,重测信度(4周后)为0.71。问卷具有良好的结构效度、聚合效度、区分效度和效标关联效度。问卷满足跨性别和跨年级的尺度测量等值性。结论:青少年生命敬畏感问卷信效度良好,可用于相关研究。

关键词：生命敬畏感青少年问卷编制信度效度

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Limiting Behavior of Delayed Sums of φ-Mixing under a Non-Identical Distribution Setup

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Journal of Mathematical Research and Exposition 2008年第3期28卷 628-636页

作者： chen ping yan LI Feng Ling Department of Mathematics Jinan University Guangdong 510630 China Department of Statistics Jinan University Guangdong 510630 China

We present an integral test to determine the limiting behavior of delayed sums under a non-identical distribution setup for φ-mixing sequence, and deduce Chover-type laws of the iterated logarithm for them. These com... 详细信息

关键词： stable distribution laws of the iterated logarithm delayed sum integral test

经椎板间入路与椎间孔入路脊柱内镜减压术治疗L_(5)-S_(1)节段钙化型腰椎间盘突出症的疗效分析

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颈腰痛杂志 2024年第2期45卷 330-334,385页

作者：林亮陈彦平赵冲李长宽河北省沧州中西医结合医院脊柱脊髓外二科河北沧州061000

目的对比分析经椎间孔入路和椎板间入路行脊柱内镜减压术治疗L_(5)-S_(1)节段钙化型腰椎间盘突出症(calcified lumbar disc herniation,CLDH)的疗效。方法回顾性分析该科2019年1月~2022年1月采用脊柱内镜手术治疗的67例L_(5)-S_(1)节段C... 详细信息

目的对比分析经椎间孔入路和椎板间入路行脊柱内镜减压术治疗L_(5)-S_(1)节段钙化型腰椎间盘突出症(calcified lumbar disc herniation,CLDH)的疗效。方法回顾性分析该科2019年1月~2022年1月采用脊柱内镜手术治疗的67例L_(5)-S_(1)节段CLDH患者资料,按照手术方法分组:采用椎板间入路经皮内镜下椎间盘切除术(percutaneous endoscopic interlaminar discectomy,PEID)34例,纳入PEID组;采用经皮椎间孔入路经皮内镜下椎间盘切除术(percutaneous endoscopic transforaminal discectomy,PETD)治疗33例,纳入PETD组。统计两组患者的临床资料、手术情况和术后疗效指标,并进行分组比较。结果两组患者的性别、年龄、病程、BMI、钙化类型、术后随访时间等临床资料差异均无统计学意义(P>0.05)。与PETD组相比,PEID组的手术时间显著缩短,X线透视次数显著减少(P0.05)。与术前相比,两组患者术后1 d、3个月和1年的VAS评分和ODI评分均显著降低(P0.05)。末次随访时,PEID组的优良率为91.2%,PETD组为87.9%,差异无统计学意义(P>0.05)。并发症方面,PETD组术后有1例出现下肢感觉异常,1例有残留的突出髓核组织未取净;PEID组有2例术后出现下肢感觉异常,1例出现硬膜撕裂但未出现脑脊液漏。两组并发症差异无统计学意义(P>0.05)。结论PEID和PETD治疗CLDH均可取得满意的减压效果,前者手术时间短、X线透视少;后者可在局部麻醉下开展,避免了全麻所致的麻醉风险。

关键词：钙化型腰椎间盘突出症脊柱内镜经椎间孔入路经椎板间入路 L_(5)-S_(1)节段

颈部血管彩超诊断动脉硬化性脑梗死的临床效果评价

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中国医疗器械信息 2024年第7期30卷 84-87页

作者：陈燕萍黄素珍鞠芳福建中医药大学附属第三人民医院福建福州350108

目的:探究对动脉硬化性脑梗死使用颈部血管彩超进行诊断的效果。方法:选择2020年1月~2023年10月60例疑似动脉硬化性脑梗死患者作为研究对象。患者诊断接受颈部血管彩超,检查后诊断结果以血管造影数字减影为依据,进行诊断效果评价。结果... 详细信息

目的:探究对动脉硬化性脑梗死使用颈部血管彩超进行诊断的效果。方法:选择2020年1月~2023年10月60例疑似动脉硬化性脑梗死患者作为研究对象。患者诊断接受颈部血管彩超,检查后诊断结果以血管造影数字减影为依据,进行诊断效果评价。结果:颈部血管彩超的诊断效能与血管造影数字减影对比无显著差异(P>0.05)。动脉硬化性脑梗死检出的40例患者中,内膜厚度(1.34±0.18)mm,血管闭塞12.50%。轻度不规则斑块32.50%,规则型斑块10.00%。结论:颈部血管彩超用于动脉硬化性脑梗死患者的临床诊断效果显著。

关键词：动脉硬化脑梗死颈部血管彩超诊断效能