Judith A Groner1,2, Ana M Rule3,4, Sharon A McGrath-Morrow3,5, Joseph M Collaco3,5, Angela Moss6, Susanne E Tanski3,7, Robert McMillen3,8, Regina M Whitmore3, Jonathan D Klein3,9, Jonathan P Winickoff3,10, Karen Wilson3,11. 1. AAP Julius B. Richmond Center of Excellence, Elk Grove Village, IL, USA. Judith.groner@nationwidechildrens.org. 2. Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA. Judith.groner@nationwidechildrens.org. 3. AAP Julius B. Richmond Center of Excellence, Elk Grove Village, IL, USA. 4. Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 5. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 6. Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Denver, Aurora, CO, USA. 7. Geisel School of Medicine at Dartmouth, Lebanon, NH, USA. 8. Social Science Research Center, Mississippi State University, Starkville, MS, USA. 9. Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA. 10. Harvard Medical School, Massachusetts General Hospital Division of General Pediatrics, Boston, MA, USA. 11. Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Abstract
INTRODUCTION: The purpose of this study was to examine the relationships between screening questions for secondhand smoke (SHS) exposure and biomarker results using hair nicotine levels. Our ultimate goal was to develop sensitive and valid screening tools in pediatric clinical settings for SHS exposure. METHODS: Investigators developed a core set of questions regarding exposure. Data from two separate ongoing studies of well children and those with bronchopulmonary dysplasia (BPD) were used to assess the concordance between responses and hair nicotine levels. Sensitivity, a positive predictive value, and accuracy were examined. RESULTS: There was no single question with similar sensitivity in both populations. The question with the highest positive predictive value (90.8% well-cohort and 84.6% BPD cohort) for both the groups was whether the child had been exposed to in-home smoking in the last 7 days. The question with the highest accuracy for both groups was the number of smokers at home (0 vs ≥ 1), with an accuracy of 72.4% for well children and 79.0% for the BPD cohort. CONCLUSIONS: There was a wide variability in the performance of specific questions. These data demonstrate that a "one-size-fits-all" approach to screening for secondhand tobacco smoke exposure may not be appropriate for all pediatric populations.
INTRODUCTION: The purpose of this study was to examine the relationships between screening questions for secondhand smoke (SHS) exposure and biomarker results using hair nicotine levels. Our ultimate goal was to develop sensitive and valid screening tools in pediatric clinical settings for SHS exposure. METHODS: Investigators developed a core set of questions regarding exposure. Data from two separate ongoing studies of well children and those with bronchopulmonary dysplasia (BPD) were used to assess the concordance between responses and hair nicotine levels. Sensitivity, a positive predictive value, and accuracy were examined. RESULTS: There was no single question with similar sensitivity in both populations. The question with the highest positive predictive value (90.8% well-cohort and 84.6% BPD cohort) for both the groups was whether the child had been exposed to in-home smoking in the last 7 days. The question with the highest accuracy for both groups was the number of smokers at home (0 vs ≥ 1), with an accuracy of 72.4% for well children and 79.0% for the BPD cohort. CONCLUSIONS: There was a wide variability in the performance of specific questions. These data demonstrate that a "one-size-fits-all" approach to screening for secondhand tobacco smoke exposure may not be appropriate for all pediatric populations.
Authors: Jakobi Johnson; Karen M Wilson; Chuan Zhou; David P Johnson; Chén C Kenyon; Joel S Tieder; Andrea Dean; Rita Mangione-Smith; Derek J Williams Journal: J Hosp Med Date: 2019-04 Impact factor: 2.960
Authors: Faustine D Ramirez; Judith A Groner; Joel L Ramirez; Cindy T McEvoy; Judith A Owens; Charles E McCulloch; Michael D Cabana; Katrina Abuabara Journal: Acad Pediatr Date: 2020-11-05 Impact factor: 3.107
Authors: Karen M Wilson; Angela Moss; Michelle Lowary; Jessica Gambino; Jonathan D Klein; Gwendolyn S Kerby; Melbourne Hovell; Jonathan P Winickoff Journal: Hosp Pediatr Date: 2020-12-03
Authors: Joseph M Collaco; Brianna C Aoyama; Jessica L Rice; Sharon A McGrath-Morrow Journal: Expert Rev Respir Med Date: 2021-06-17 Impact factor: 3.772