External Validation of the Predicting Asthma Risk in Children (PARC) tool in a clinical cohort.

Berger, Daria O; Pedersen, Eva S L; Mallet, Maria C; de Jong, Carmen C M; Usemann, Jakob; Regamey, Nicolas; Spycher, Ben D; Ardura-Garcia, Cristina; Kuehni, Claudia E (2022). External Validation of the Predicting Asthma Risk in Children (PARC) tool in a clinical cohort. Pediatric pulmonology, 57(11), pp. 2715-2723. Wiley-Blackwell 10.1002/ppul.26088

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INTRODUCTION

The Predicting Asthma Risk in Children (PARC) tool uses questionnaire-based respiratory symptoms collected from preschool children to predict asthma risk 5 years later. The tool was developed and validated in population cohorts but not validated using a clinical cohort. We aimed to externally validate the PARC tool in a paediatric pulmonology clinic setting.

METHODS

The Swiss Paediatric Airway Cohort (SPAC) is a prospective cohort of children seen in paediatric pulmonology clinics across Switzerland. We included children aged 1-6 years with cough or wheeze at baseline who completed the 2-year follow up questionnaire. The outcome was defined as current wheeze plus use of asthma medication. We assessed performance using: sensitivity, specificity, negative and positive predictive value (NPV, PPV), area under the curve (AUC), scaled Brier's score and Nagelkerke's R2 scores. We compared performance in SPAC to that in the original population, the Leicester Respiratory Cohort (LRC).

RESULTS

Among 346 children included, 125 (36%) reported the outcome after 2 years. At a PARC score of 4: sensitivity was higher (95% vs 79%), specificity lower (14% vs 57%), and NPV and PPV comparable (0.84 vs. 0.87 and 0.37 vs.0.42) in SPAC versus LRC. AUC (0.71 vs 0.78), R2 (0.18 vs 0.28) and Brier's scores (0.13 vs 0.22) were lower in SPAC.

CONCLUSIONS

The PARC tool shows some clinical utility, particularly for ruling out the development of asthma in young children, but performance limitations highlight the need for new prediction tools to be developed specifically for the clinical setting. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Pneumology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Berger, Daria Olena, Pedersen, Eva Sophie Lunde, Mallet, Maria Christina, de Jong, Carmen Cornelia Maria, Spycher, Ben, Ardura Garcia, Cristina, Kühni, Claudia

Subjects:

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

ISSN:

8755-6863

Publisher:

Wiley-Blackwell

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Anette van Dorland

Date Deposited:

08 Aug 2022 09:16

Last Modified:

06 Aug 2023 00:25

Publisher DOI:

10.1002/ppul.26088

PubMed ID:

35929421

Uncontrolled Keywords:

Asthma PARC SPAC children external validation prediction preschool risk wheeze

BORIS DOI:

10.48350/171786

URI:

https://boris.unibe.ch/id/eprint/171786

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