Die standardisierte Bewertung nächtlicher Atemgeräusche

Atemnot und Husten sind quälende Symptome, welche bei einer Vielzahl von Erkrankungen auftreten und die Lebensqualität deutlich beeinträchtigen. Gerade nachts sind diese Symptome jedoch nur schwer erfassbar. Mit Hilfe des Lung Sound Monitorings gelingt eine zuverlä...

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1. Verfasser: Koch, Roland
Beteiligte: Köhler, Ulrich (Prof. Dr.) (BetreuerIn (Doktorarbeit))
Format: Dissertation
Sprache:Deutsch
Veröffentlicht: Philipps-Universität Marburg 2012
Innere Medizin
Ausgabe:http://dx.doi.org/10.17192/z2012.0873
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author2 Köhler, Ulrich (Prof. Dr.)
author2_role ths
last_indexed 2013-03-22T23:59:59Z
topic Lungengeräusche
wheezing
Lungengeräusche
Husten
Wheezing
assessment
Husten
Atemgeräusche
Langzeitregistrierung
nocturnal
Wheezing
lung sounds
Medizin, Gesundheit
Atemgeräusche
cough
Langzeitregistrierung
spellingShingle Lungengeräusche
wheezing
Lungengeräusche
Husten
Wheezing
assessment
Husten
Atemgeräusche
Langzeitregistrierung
nocturnal
Wheezing
lung sounds
Medizin, Gesundheit
Atemgeräusche
cough
Langzeitregistrierung
standardized assessment of nocturnal lung sounds
Die standardisierte Bewertung nächtlicher Atemgeräusche
Koch, Roland
contents standardized assessment of nocturnal lung sounds
building Medizin
publishDate 2012
era_facet 2012
format Dissertation
oai_set_str_mv doc-type:doctoralThesis
open_access
ddc:610
xMetaDissPlus
first_indexed 2012-10-12T00:00:00Z
doi_str_mv http://dx.doi.org/10.17192/z2012.0873
edition http://dx.doi.org/10.17192/z2012.0873
license_str http://archiv.ub.uni-marburg.de/adm/urhg.html
title_alt Standardized assessment of nocturnal lung sounds
description Atemnot und Husten sind quälende Symptome, welche bei einer Vielzahl von Erkrankungen auftreten und die Lebensqualität deutlich beeinträchtigen. Gerade nachts sind diese Symptome jedoch nur schwer erfassbar. Mit Hilfe des Lung Sound Monitorings gelingt eine zuverlässige Aufzeichnung von nächtlichen akustischen Symptomen. Die Analyse der Messdaten erfolgt durch erfahrene Untersucher anhand eines standardisierten Bewertungsschemas. Ziel dieser Arbeit ist es, Parameter dieses Schemas auf Reliabilität und Beobachterkonkordanz zu überprüfen. Hierfür wurden aus der MARS-Datenbank insgesamt 36 Segmente von neun verschiedenen Patienten ausgesucht und in zwei Bewertungsdurchgänge (Testsets) randomisiert. Acht Studienteilnehmer bewerteten diese Segmente nach einer Schulungsveranstaltung. Reliabilität und Beobachterkonkordanz wurden für Parameter mit nominalem Skalenniveau anhand des Kappa- Koeffizienten (k) und für ordinal verteilte Daten mittels des Spearman-Brown- Koeffizienten (Spearmans Rho, r) berechnet. Der Parameter Wheezingrate (tWheez/tTot) ist reliabel (r = 0,858 [Minimum 0,693 - Maximum 0,937]) und valide (r = 0,747 [0,571 - 0,859]), ebenso der Parameter Hustenzahl (Hustenereignisse pro Zeiteinheit, Reliabilität r = 0,992 [0,909-0,999]; Beobachterkonkordanz r = 0,994 [0,923 - 0,999]) und Hustenrate (tCough/tTot, Reliabilität r = 0,972 [0,909 - 0,999]; Beobachterkonkordanz r = 0,964 [0,860 - 0,997]). Lediglich der Parameter Hustenart (Reliabilität k = 0,100 [-0,161 - 0,476]; Beobachterkonkordanz k = - 0,043 [-0,391 - 0,244]) zeigte eine nur zufällig häufige Übereinstimmung. Hustenrate und Hustenzahl stehen in einem eindeutigen linearen Zusammenhang (p<0,01). Die mittlere Hustendauer wurde mit 2,77 Sekunden berechnet. Anhand dieser Ergebnisse wurde das Bewertungsschema weiterentwickelt. Es dient als Grundlage für das Erstellen einer Referenzatenbank. Mithilfe dieser werden Algorithmen zur Erfassung von nächtlichen akustischen Symptomen entwickelt und erprobt.
title Die standardisierte Bewertung nächtlicher Atemgeräusche
title_short Die standardisierte Bewertung nächtlicher Atemgeräusche
title_full Die standardisierte Bewertung nächtlicher Atemgeräusche
title_fullStr Die standardisierte Bewertung nächtlicher Atemgeräusche
title_full_unstemmed Die standardisierte Bewertung nächtlicher Atemgeräusche
title_sort Die standardisierte Bewertung nächtlicher Atemgeräusche
publisher Philipps-Universität Marburg
ref_str_mv references
author Koch, Roland
language German
dewey-raw 610
dewey-search 610
genre Medical sciences, Medicine
genre_facet Medical sciences, Medicine
topic_facet Medizin, Gesundheit
url http://archiv.ub.uni-marburg.de/diss/z2012/0873/pdf/drk.pdf
institution Innere Medizin
thumbnail http://archiv.ub.uni-marburg.de/diss/z2012/0873/cover.png
spelling diss/z2012/0873 2013-03-22 standardized assessment of nocturnal lung sounds 2012 2012-10-12 http://dx.doi.org/10.17192/z2012.0873 Standardized assessment of nocturnal lung sounds Atemnot und Husten sind quälende Symptome, welche bei einer Vielzahl von Erkrankungen auftreten und die Lebensqualität deutlich beeinträchtigen. Gerade nachts sind diese Symptome jedoch nur schwer erfassbar. Mit Hilfe des Lung Sound Monitorings gelingt eine zuverlässige Aufzeichnung von nächtlichen akustischen Symptomen. Die Analyse der Messdaten erfolgt durch erfahrene Untersucher anhand eines standardisierten Bewertungsschemas. Ziel dieser Arbeit ist es, Parameter dieses Schemas auf Reliabilität und Beobachterkonkordanz zu überprüfen. Hierfür wurden aus der MARS-Datenbank insgesamt 36 Segmente von neun verschiedenen Patienten ausgesucht und in zwei Bewertungsdurchgänge (Testsets) randomisiert. Acht Studienteilnehmer bewerteten diese Segmente nach einer Schulungsveranstaltung. Reliabilität und Beobachterkonkordanz wurden für Parameter mit nominalem Skalenniveau anhand des Kappa- Koeffizienten (k) und für ordinal verteilte Daten mittels des Spearman-Brown- Koeffizienten (Spearmans Rho, r) berechnet. Der Parameter Wheezingrate (tWheez/tTot) ist reliabel (r = 0,858 [Minimum 0,693 - Maximum 0,937]) und valide (r = 0,747 [0,571 - 0,859]), ebenso der Parameter Hustenzahl (Hustenereignisse pro Zeiteinheit, Reliabilität r = 0,992 [0,909-0,999]; Beobachterkonkordanz r = 0,994 [0,923 - 0,999]) und Hustenrate (tCough/tTot, Reliabilität r = 0,972 [0,909 - 0,999]; Beobachterkonkordanz r = 0,964 [0,860 - 0,997]). Lediglich der Parameter Hustenart (Reliabilität k = 0,100 [-0,161 - 0,476]; Beobachterkonkordanz k = - 0,043 [-0,391 - 0,244]) zeigte eine nur zufällig häufige Übereinstimmung. Hustenrate und Hustenzahl stehen in einem eindeutigen linearen Zusammenhang (p<0,01). Die mittlere Hustendauer wurde mit 2,77 Sekunden berechnet. Anhand dieser Ergebnisse wurde das Bewertungsschema weiterentwickelt. Es dient als Grundlage für das Erstellen einer Referenzatenbank. Mithilfe dieser werden Algorithmen zur Erfassung von nächtlichen akustischen Symptomen entwickelt und erprobt. opus:4513 Die standardisierte Bewertung nächtlicher Atemgeräusche French,C.L., Irwin,R.S., Curley,F.J., and Krikorian,C.J. (1998). Impact of chronic cough on quality of life. Arch. Intern. Med 158, 1657-1661. 1998 Impact of chronic cough on quality of life Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am. J. Respir. Crit Care Med. 163, 1256-1276. 2007 Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary Falconer,A., Oldman,C., and Helms,P. (1993). 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Validity and reliability of acoustic analysis of respiratory sounds in infants 2012-09-27 urn:nbn:de:hebis:04-z2012-08738 ths Prof. Dr. Köhler Ulrich Köhler, Ulrich (Prof. Dr.) Philipps-Universität Marburg Koch, Roland Koch Roland
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