OBJECTIVES: To examine parent-reported signs and symptoms as antecedents of wheezing in preschool children with previous moderate to severe wheezing episodes, and to determine the predictive capacity of these symptom patterns for wheezing events. STUDY DESIGN:Parents (n = 238) of children age 12 to 59 months with moderate-to-severe intermittent wheezing enrolled in a year-long clinical trial completed surveys that captured signs and symptoms at the start of a respiratory tract illness (RTI). Sensitivity, specificity, negative predictive value, and positive predictive value (PPV) for each symptom leading to wheezing during that RTI were calculated. RESULTS: The most commonly reported first symptom categories during the first RTI were "nose symptoms" (41%), "significant cough" (29%), and "insignificant cough" (13%). The most reliable predictor of subsequent wheezing was significant cough, which had a specificity of 78% and a PPV of 74% for predicting wheezing. CONCLUSIONS:Significant cough is the most reliable antecedent of wheezing during an RTI. It may be useful to consider individualized symptom patterns as a component of management plans intended to minimize wheezing episodes.
RCT Entities:
OBJECTIVES: To examine parent-reported signs and symptoms as antecedents of wheezing in preschool children with previous moderate to severe wheezing episodes, and to determine the predictive capacity of these symptom patterns for wheezing events. STUDY DESIGN: Parents (n = 238) of children age 12 to 59 months with moderate-to-severe intermittent wheezing enrolled in a year-long clinical trial completed surveys that captured signs and symptoms at the start of a respiratory tract illness (RTI). Sensitivity, specificity, negative predictive value, and positive predictive value (PPV) for each symptom leading to wheezing during that RTI were calculated. RESULTS: The most commonly reported first symptom categories during the first RTI were "nose symptoms" (41%), "significant cough" (29%), and "insignificant cough" (13%). The most reliable predictor of subsequent wheezing was significant cough, which had a specificity of 78% and a PPV of 74% for predicting wheezing. CONCLUSIONS: Significant cough is the most reliable antecedent of wheezing during an RTI. It may be useful to consider individualized symptom patterns as a component of management plans intended to minimize wheezing episodes.
Authors: Robert S Zeiger; David Mauger; Leonard B Bacharier; Theresa W Guilbert; Fernando D Martinez; Robert F Lemanske; Robert C Strunk; Ronina Covar; Stanley J Szefler; Susan Boehmer; Daniel J Jackson; Christine A Sorkness; James E Gern; H William Kelly; Noah J Friedman; Michael H Mellon; Michael Schatz; Wayne J Morgan; Vernon M Chinchilli; Hengameh H Raissy; Elizabeth Bade; Jonathan Malka-Rais; Avraham Beigelman; Lynn M Taussig Journal: N Engl J Med Date: 2011-11-24 Impact factor: 91.245
Authors: Leonard B Bacharier; Theresa W Guilbert; David T Mauger; Susan Boehmer; Avraham Beigelman; Anne M Fitzpatrick; Daniel J Jackson; Sachin N Baxi; Mindy Benson; Carey-Ann D Burnham; Michael Cabana; Mario Castro; James F Chmiel; Ronina Covar; Michael Daines; Jonathan M Gaffin; Deborah Ann Gentile; Fernando Holguin; Elliot Israel; H William Kelly; Stephen C Lazarus; Robert F Lemanske; Ngoc Ly; Kelley Meade; Wayne Morgan; James Moy; Tod Olin; Stephen P Peters; Wanda Phipatanakul; Jacqueline A Pongracic; Hengameh H Raissy; Kristie Ross; William J Sheehan; Christine Sorkness; Stanley J Szefler; W Gerald Teague; Shannon Thyne; Fernando D Martinez Journal: JAMA Date: 2015-11-17 Impact factor: 56.272