BACKGROUND: Clinicians have difficulty in diagnosing asthma in preschool children with suggestive symptoms. OBJECTIVE: We sought to develop a clinical asthma prediction score for preschool children who have asthma-like symptoms for the first time. METHODS: The Prevalence and Incidence of Asthma and Mite Allergy birth cohort followed 3,963 children for 8 years. Between 0 and 4 years of age, 2,171 (55%) children reported "wheezing," "coughing at night without a cold," or both. In these children possible predictor variables for asthma were assessed at the age respiratory symptoms were first reported. Asthma was defined as wheezing, inhaled steroid prescription, or a doctor's diagnosis of asthma at both age 7 and 8 years of age. RESULTS: Eleven percent of children with symptoms at 0 to 4 years of age had asthma at 7 to 8 years of age. Eight clinical parameters independently predicted asthma at 7 to 8 years of age: male sex, postterm delivery, parental education and inhaled medication, wheezing frequency, wheeze/dyspnea apart from colds, respiratory infections, and eczema. In 72% of the cases, the model accurately discriminated between asthmatic and nonasthmatic children. A clinical risk score was developed (range, 0-55 points). Symptomatic children with a score of less than 10 points had a 3% risk, whereas children with a score of 30 points or greater had a 42% risk of asthma. CONCLUSION: A risk score based on 8 readily available clinical parameters at the time preschool children first reported asthma-like symptoms predicted the risk of asthma at 7 to 8 years of age.
BACKGROUND: Clinicians have difficulty in diagnosing asthma in preschool children with suggestive symptoms. OBJECTIVE: We sought to develop a clinical asthma prediction score for preschool children who have asthma-like symptoms for the first time. METHODS: The Prevalence and Incidence of Asthma and Mite Allergy birth cohort followed 3,963 children for 8 years. Between 0 and 4 years of age, 2,171 (55%) children reported "wheezing," "coughing at night without a cold," or both. In these children possible predictor variables for asthma were assessed at the age respiratory symptoms were first reported. Asthma was defined as wheezing, inhaled steroid prescription, or a doctor's diagnosis of asthma at both age 7 and 8 years of age. RESULTS: Eleven percent of children with symptoms at 0 to 4 years of age had asthma at 7 to 8 years of age. Eight clinical parameters independently predicted asthma at 7 to 8 years of age: male sex, postterm delivery, parental education and inhaled medication, wheezing frequency, wheeze/dyspnea apart from colds, respiratory infections, and eczema. In 72% of the cases, the model accurately discriminated between asthmatic and nonasthmatic children. A clinical risk score was developed (range, 0-55 points). Symptomatic children with a score of less than 10 points had a 3% risk, whereas children with a score of 30 points or greater had a 42% risk of asthma. CONCLUSION: A risk score based on 8 readily available clinical parameters at the time preschool children first reported asthma-like symptoms predicted the risk of asthma at 7 to 8 years of age.
Authors: Jocelyn M Biagini Myers; Eric Schauberger; Hua He; Lisa J Martin; John Kroner; Gregory M Hill; Patrick H Ryan; Grace K LeMasters; David I Bernstein; James E Lockey; S Hasan Arshad; Ramesh Kurukulaaratchy; Gurjit K Khurana Hershey Journal: J Allergy Clin Immunol Date: 2018-12-13 Impact factor: 10.793
Authors: Rita de Cássia Ribeiro Silva; Ana Marlúcia Oliveira Assis; Alvaro Augusto Cruz; Rosemeire Leovigildo Fiaccone; Silvana Dinnocenzo; Maurício Lima Barreto; Luce Alves da Silva; Laura Cunha Rodrigues; Neuza Maria Alcantara-Neves Journal: Pediatr Allergy Immunol Pulmonol Date: 2013-03 Impact factor: 1.349
Authors: Timothy S Chang; Robert F Lemanske; Theresa W Guilbert; James E Gern; Michael H Coen; Michael D Evans; Ronald E Gangnon; C David Page; Daniel J Jackson Journal: J Allergy Clin Immunol Pract Date: 2013-03