A simple asthma prediction tool for preschool children with wheeze or cough

Pescatore, Anina M.; Dogaru, Cristian M.; Dümbgen, Lutz; Silverman, Michael; Gaillard, Erol A.; Spycher, Ben D.; Kuehni, Claudia E. (2014). A simple asthma prediction tool for preschool children with wheeze or cough. Journal of allergy and clinical immunology, 133(1), 111-118.e13. Mosby 10.1016/j.jaci.2013.06.002

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

08 Faculty of Science > Department of Mathematics and Statistics > Institute of Mathematical Statistics and Actuarial Science
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Pescatore, Anina; Dogaru, Cristian; Dümbgen, Lutz; Spycher, Ben and Kühni, Claudia

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
500 Science > 510 Mathematics
600 Technology > 610 Medicine & health

ISSN:

0091-6749

Publisher:

Mosby

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

23 Jan 2014 13:00

Last Modified:

11 Sep 2017 20:03

Publisher DOI:

10.1016/j.jaci.2013.06.002

PubMed ID:

23891353

Additional Information:

Spycher and Kuehni contributed equally to this work.

Uncontrolled Keywords:

API, AUC, Area under the receiver operating characteristic curve, Asthma, Asthma Predictive Index, LASSO, Least absolute shrinkage and selection operator, children, cohort study, cough, longitudinal, persistence, prediction, prognosis, wheeze

BORIS DOI:

10.7892/boris.40003

URI:

https://boris.unibe.ch/id/eprint/40003

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