中风与神经疾病杂志2019，Vol.36Issue(8)：727-731,5.
Logistic回归及ROC曲线综合评价溶积-黏度测试法对脑卒中口咽吞咽障碍诊断的应用价值
Logistic regression and ROC curve comprehensive evaluation of the value of dissolution-viscosity test in the diagno-sis of oropharyngeal dysphagia
摘要
Abstract
Objective To investigate the application value of logistic regression and ROC curve and to comprehen-sive evaluate the dissolution-viscosity test in the diagnosis of oropharyngeal dysphagia. Methods A total of 220 stroke pa-tients who underwent treatment in our hospital from June 20 to December 2018 were enrolled. All patients underwent the ly-sis-viscosity test and video fluoroscopy (VFSS),and the logistic regression analysis was used to screen for the accumulation indicators for the diagnosis of oropharyngeal dysphagia in the viscosity test. Then the regression equation for the diagnosis of pharyngeal dysphagia was obtained. Finally,the ROC curve was used to evaluate the optimal diagnostic cutoff value and di-agnostic efficiency of the regression equation. Results Among the 220 stroke patients,98 cases were diagnosed as oropha-ryngeal dysphagia by VFSS method,89 cases were diagnosed as oropharyngeal dysphagia by V-VST method (4 cases were negative by swallowing angiography),and 131 cases were negative (13 cases were The VFSS method was diagnosed as posi-tive),that is,13 cases were missed and 4 cases were misdiagnosed. The accuracy rate was 92. 27% ,the specificity was 90. 08% ,and the sensitivity was 86. 73% . Multivariate logistic results showed oxygen saturation,oral residue,and swallo-wing. The number of times and the correlation between pharyngeal residue and oropharyngeal dysphagia were 0. 134, 19. 394/74. 301 and 172. 344,respectively,which were all statistically significant (P<0. 05). The probability prediction model of pancreatic cancer was P =1/[ 1 + e-(181. 651-2. 010 Oxygen saturation+2. 965 oral residual+4. 308965 Oral residual+5. 149 Pharyngeal residue) ], the new variable P has an AUC of 0. 999,which is much higher than other variables. The new variable P test has the best diag-nostic performance. Conclusion The regression model of combined oxygen saturation,oral residue,swallowing frequency and pharyngeal residue in the test of deposition-viscosity test can improve the diagnostic efficiency of oropharyngeal dyspha-gia and improve its diagnostic sensitivity and specificity. Higher clinical application value is worth further promotion.关键词
Logistic回归/ ROC曲线/ 溶积-黏度测试法/ 口咽吞咽障碍Key words
Logistic regression/ ROC curve/ Deposition-viscosity test/ Oropharyngeal dysphagia分类
医药卫生引用本文复制引用
尚倩倩,董湘平,宋雪,罗敏,邓颖颖,李媛..Logistic回归及ROC曲线综合评价溶积-黏度测试法对脑卒中口咽吞咽障碍诊断的应用价值[J].中风与神经疾病杂志,2019,36(8):727-731,5.基金项目
四川省科技厅重点研发项目(No. 2017SZ0007) （No. 2017SZ0007）
