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[目的]评价在不同预警参数下,麻疹疫情自动预警系统的有效性;评价麻疹疫情自动预警系统的预警及时性情况;浅析系统实用性。[方法]以灵敏度、特异度等指标评价麻疹疫情自动预警系统的有效性;以预警信号数据信息的时间点间隔中位数评价麻疹疫情自动预警系统的及时性;对疾控中心人员就使用该系统的问题进行访谈,对系统实用性作定性评估。[结果]在所评价的时间段内,33个试点县(区)自动预警系统共发出麻疹预警信息2025次,试点地区对其中1条预警信号未作出响应;作了初步判断的2024条预警信息中,有2.87%信号与麻疹疑似流行有关;对预警信息的时间间隔分析表明,首例病人发病时间与预警时间的间隔为12d,预警时间与填报时间、现场调查完成时间的间隔均为0d;疑似病例48h完整调查率为89.7%;在P60、P70、P80和P90警戒限,麻疹的预警灵敏度均为100%,特异度大多在30%～70%之间。[结论]建立在病例实时直报的传染病监测系统基础上的传染病自动预警系统的及时性良好,试点地区麻疹预警的敏感性很高,特异度相对较低。根据目前的试点地区的效能分析结果,P90可能是较为合适的预警阈值。
[Objective] To evaluate the validity of automatic warning system of measles epidemic under different warning parameters; to evaluate the early warning and timely situation of automatic warning system of measles epidemic; to analyze the practicability of the system. [Methods] The validity of the automatic warning system for measles epidemic situation was evaluated by sensitivity, specificity and other indicators. The timeliness of the automatic warning system for measles epidemic was evaluated by the median of the time interval of the warning signal data. System issues interviews, qualitative evaluation of the system for practicality. [Results] During the period of evaluation, the warning system of measles was issued by the automatic pilot warning system of 33 pilot counties (districts) altogether 2025 times, and the pilot area did not respond to one of the early warning signals; 2024 preliminary warning information , 2.87% of the signals were related to the suspected epidemic of measles. The analysis of the time interval of the early warning information showed that the interval between the onset time and the early warning time of the first patient was 12d, the prewarning time and the filling time and the time of the field survey were all 0d; The complete investigation rate of suspected cases 48h was 89.7%. At the warning limits of P60, P70, P80 and P90, the precautionary sensitivity of measles was 100% and the specificity was mostly between 30% and 70%. [Conclusion] The timeliness of automatic warning system for infectious diseases based on the real-time direct reporting of infectious disease surveillance system is good. The sensitivity of measles early warning in pilot areas is high and the specificity is relatively low. According to the results of the current pilot area performance analysis, P90 may be a more appropriate warning threshold.