A simple asthma prediction tool for preschool children with wheeze or cough
| Autor: | Michael Silverman, Anina M. Pescatore, Lutz Duembgen, Ben D. Spycher, Erol A. Gaillard, Cristian Dogaru, Claudia E. Kuehni |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Risk Pediatrics medicine.medical_specialty Immunology Population Logistic regression Cohort Studies 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Wheeze Prevalence medicine Humans Immunology and Allergy 030212 general & internal medicine Child education Respiratory Sounds Asthma education.field_of_study business.industry Infant Allergens Prognosis medicine.disease United Kingdom 3. Good health Cough 030228 respiratory system Brier score Child Preschool Cohort Bronchitis Female medicine.symptom business Follow-Up Studies Cohort study |
| Zdroj: | Journal of Allergy and Clinical Immunology The Journal of allergy and clinical immunology |
| DOI: | 10.1016/j.jaci.2013.06.002 |
| Popis: | Background Many preschool children have wheeze or cough, but only some have asthma later. Existing prediction tools are difficult to apply in clinical practice or exhibit methodological weaknesses. Objective We sought to develop a simple and robust tool for predicting asthma at school age in preschool children with wheeze or cough. Methods From a population-based cohort in Leicestershire, United Kingdom, we included 1- to 3-year-old subjects seeing a doctor for wheeze or cough and assessed the prevalence of asthma 5 years later. We considered only noninvasive predictors that are easy to assess in primary care: demographic and perinatal data, eczema, upper and lower respiratory tract symptoms, and family history of atopy. We developed a model using logistic regression, avoided overfitting with the least absolute shrinkage and selection operator penalty, and then simplified it to a practical tool. We performed internal validation and assessed its predictive performance using the scaled Brier score and the area under the receiver operating characteristic curve. Results Of 1226 symptomatic children with follow-up information, 345 (28%) had asthma 5 years later. The tool consists of 10 predictors yielding a total score between 0 and 15: sex, age, wheeze without colds, wheeze frequency, activity disturbance, shortness of breath, exercise-related and aeroallergen-related wheeze/cough, eczema, and parental history of asthma/bronchitis. The scaled Brier scores for the internally validated model and tool were 0.20 and 0.16, and the areas under the receiver operating characteristic curves were 0.76 and 0.74, respectively. Conclusion This tool represents a simple, low-cost, and noninvasive method to predict the risk of later asthma in symptomatic preschool children, which is ready to be tested in other populations. |
| Databáze: | OpenAIRE |
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