Setting definitions of childhood asthma in epidemiologic studies

• Type: Article in International Scientific Journal
• Date: 2019

Authors

Silva, D (Author) Other; Severo, M (Author) Other; Paciência, I (Author) Other; Rufo, J (Author) Other; Martins, C (Author) Other; Moreira, Pedro (Author) FCNAUP; Padrão, Patrícia (Author) FCNAUP; Delgado, L (Author) Other; Moreira, André (Author) FMUP

Journal

Title: Pediatric Allergy and Immunology

ISSN: 0905-6157

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 17 Citations

Scopus - 17 Citations

Scientific classification

CORDIS: Health sciences

FOS: Medical and Health sciences

CORDIS: Health sciences

Other information

Authenticus ID: P-00Q-Z1W

DOI: 10.1111/pai.13111

Abstract (EN): Background: The definitions of childhood asthma differ among epidemiological studies. We aimed to compare the diagnostic accuracy and agreement of previous asthma definitions and to evaluate questionnaire-driven asthma definition patterns. Methods: Data on 808 participants aged 7-12 years from 20 schools were analyzed. Asthma definitions based on symptoms assessed by questionnaire, parent-reported medical asthma diagnosis, current use of asthma medication, airway reversibility after bronchodilatation, and increased (¿35 ppb) levels of exhaled nitric oxide (eNO) were compared with a gold standard (medical diagnosis of asthma with asthma symptoms in the past 12 months and/or airway reversibility). Concordance was assessed by Cohen's kappa. Data-driven analysis was applied to the questionnaire, and six scores were determined ¿asthma,¿ ¿rhinitis,¿ ¿cough,¿ ¿non-specific respiratory symptoms,¿ ¿treated asthma,¿ and ¿uncontrolled asthma.¿ Tree decisions were built using these scores. Results: Definitions of asthma based on respiratory symptoms, airway reversibility, and parent-reported medical diagnosis had a low sensitivity but high specificity. Agreement between reported and objective measures was poor. Parent-reported medical asthma diagnosis, but not reversibility or eNO, was able to predict questionnaire-driven symptom patterns. Decision trees indicated that those with recent non-specific respiratory symptoms had a higher probability of positive bronchodilation. Conclusion: A standardized operational definition of asthma should include a composite score based on reported asthma medical diagnosis, symptoms, and lung function. © 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Language: English

Type (Professor's evaluation): Scientific