呼氣一氧化碳測量儀評估年輕軍人吸菸習慣之準確性分析

The Diagnostic Accuracy of Carbon Monoxide Breathalyzer (COB) in Assessing Smoking Habits of Young Soldiers

林祖佑(Tsu-You Lin) ； 佘振興(Jenn-Shing Sher) ； 程文祺(Wen-Chi Chen) ； 魯子全(Tzu-Chuan Lu) ； 陳聲平(Sheng-Pyng Chen) ； 洪淵庭(Yieng-Ting Hung)

《中華職業醫學雜誌》 17卷4期 (2010/10) Pp. 279-288

https://doi.org/10.30027/CJOM.201010.0006

摘要

Background: The optimal cut-off level recommended by manufacturers of carbon monoxide breathalyzer (COB) is often adopted in soldiers' smoking cessation; however, the data obtained doesn't always correspond to the real smoking habits. This research aimed at evaluating the optimal cut-off level of COB and further analyzing its accuracy when assesseing smoking habit in young soldiers, which shall offer a more reliable basis for following programs.
Methods: Self-reported questionnaires and exhaled carbon monoxide (CO) detection by COB were performed by 117 soldiers from various camps all over Taiwan. Based on the self-reported smoking status, soldiers who smoked less than 10 cigarettes a day were defined as ”Group A”, while more than 10 cigarettes as ”Group B”. Under this gold standard, 0-10 ppm of carbon monoxide concentration was taken as cut-off level and the sensitivity, specificity of each level was calculated. The diagnostic accuracy was analysed with receiver operating characteristic (ROC) curve.
Results: Of the total population (average age 25.2±6.2 years), 31 and 86 subjects were classified to Group A and B, respectively. The mean value of exhaled CO was 12.6±10.8 ppm, constituted by Group A at 3.3±2.2 ppm and Group B at 16.0±10.1 ppm (p＜0.001). The optimal cut-off level was 6 ppm with a sensitivity of 86%, specificity of 94% and positive likelihood ratio (LR+) as 13.3. The area under ROC curve (AUC) was 0.923 (95%C.I.＝0.860-0.985).
Conclusion: After the analysis of ROC curve, we found that 6 ppm should be the optimal cut-off level of exhaled CO for distinguishing between two smoking habits in our population and that COB is still an excellent diagnostic tool for assessing smoking habits in young soldiers.

關鍵字

呼氣一氧化碳測量儀 ； 吸菸習慣 ； ROC曲線 ； 切點值

並列摘要

Background: The optimal cut-off level recommended by manufacturers of carbon monoxide breathalyzer (COB) is often adopted in soldiers' smoking cessation; however, the data obtained doesn't always correspond to the real smoking habits. This research aimed at evaluating the optimal cut-off level of COB and further analyzing its accuracy when assesseing smoking habit in young soldiers, which shall offer a more reliable basis for following programs.
Methods: Self-reported questionnaires and exhaled carbon monoxide (CO) detection by COB were performed by 117 soldiers from various camps all over Taiwan. Based on the self-reported smoking status, soldiers who smoked less than 10 cigarettes a day were defined as ”Group A”, while more than 10 cigarettes as ”Group B”. Under this gold standard, 0-10 ppm of carbon monoxide concentration was taken as cut-off level and the sensitivity, specificity of each level was calculated. The diagnostic accuracy was analysed with receiver operating characteristic (ROC) curve.
Results: Of the total population (average age 25.2±6.2 years), 31 and 86 subjects were classified to Group A and B, respectively. The mean value of exhaled CO was 12.6±10.8 ppm, constituted by Group A at 3.3±2.2 ppm and Group B at 16.0±10.1 ppm (p＜0.001). The optimal cut-off level was 6 ppm with a sensitivity of 86%, specificity of 94% and positive likelihood ratio (LR+) as 13.3. The area under ROC curve (AUC) was 0.923 (95%C.I.＝0.860-0.985).
Conclusion: After the analysis of ROC curve, we found that 6 ppm should be the optimal cut-off level of exhaled CO for distinguishing between two smoking habits in our population and that COB is still an excellent diagnostic tool for assessing smoking habits in young soldiers.

並列關鍵字

carbon monoxide breathalyzer ； smoking habits ； ROC curve ； cut-off level