Application of Set Theory for diagnosis of uncontrolled asthma in children

Autor: Dias, Flávia dos Santos
Přispěvatelé: Alves, Rogério Lopes Rufino, Kuschnir, Fábio Chigres, Fírmida, Mônica de Cássia, Klajman, Adriana Burlá
Jazyk: portugalština
Rok vydání: 2017
Předmět:
Zdroj: Biblioteca Digital de Teses e Dissertações da UERJ
Universidade do Estado do Rio de Janeiro (UERJ)
instacron:UERJ
Popis: Submitted by Boris Flegr (boris@uerj.br) on 2021-01-05T19:39:38Z No. of bitstreams: 1 Flavia dos Santos Dias Dissertacao completa.pdf: 1848789 bytes, checksum: cb26f5b7c7cc3d5b1cb1007095cd8ed1 (MD5) Made available in DSpace on 2021-01-05T19:39:38Z (GMT). No. of bitstreams: 1 Flavia dos Santos Dias Dissertacao completa.pdf: 1848789 bytes, checksum: cb26f5b7c7cc3d5b1cb1007095cd8ed1 (MD5) Previous issue date: 2017-12-14 The evaluation of asthma control can be performed through a questionnaire such as childhood Asthma Control Test (c-ACT). Spirometry is also a useful tool for assessing the severity of asthma. Indices such as forced expiratory volume in the 1st second (FEV1) and FEV1 ratio by forced vital capacity (FEV1 / FVC) are considered to be more relevant for dimensioning severity than for following asthmatic patients. The hypothesis we developed is that they are also important for assessing asthma control, such as the c-ACT questionnaire. Objective: To identify uncontrolled and controlled asthmatic patients in the pediatric age range from 7 to 11 year-old using the c-ACT, FEV1 and FEV1 / FVC questionnaire. Method: transversal and multicentric work in children with asthma. On the same day of outpatient care, c-ACT was applied, and spirometry was performed. Three parameters were considered to indicate non-asthma control: c-ACT 0.05). The respective results of c-ACT, FEV1 and FEV1 / FVC were for: sensitivity 55%, 89%, 90%; specificity 76%, 90% and 86.5%; Kappa c-ACT with FEV1 0.014 and Kappa c-ACT with FEV1 / FVC -0.010. After that it was identified that the best association of two variables was c-ACT with FEV1 with sensitivity of 86.21%, specificity, PPV 100% and NPV 84%. We performed the exploratory analysis and the ROC curve that identified the best diagnostic point for the sum of c-ACT and FEV1%, which was 0,05). Os respectivos resultados do c-ACT, VEF1 e VEF1/CVF foram para: sensibilidade 55%, 89%, 90%; especificidade 76%, 90% e 86,5%; Kappa c-ACT com VEF1 0,014 e Kappa c-ACT com VEF1/CVF -0,010. Após essa etapa, foi identificada que a melhor associação de duas variáveis foi a do c-ACT com o VEF1 com sensibilidade de 86,21%, especificidade, VPP 100% e VPN 84%. Foi feita a análise exploratória e a curva ROC que identificou o melhor ponto de diagnóstico para o valor da soma do c-ACT e VEF1%, que foi < 86. Esse valor foi comparado com o c-ACT e obteve sensibilidade de 100%, especificidade 97,50% e VPN 100%. O c-ACT é um instrumento prático que auxilia no diagnóstico de asma não-controlada, porém na população estudada apresentou baixa sensibilidade e especificidade. Quase a metade das crianças não são identificadas com asma não-controlada pelo c-ACT. Para que o diagnóstico melhore, o VEF1% deve ser associada ao c-ACT para identificar o não-controle da asma.
Databáze: OpenAIRE