Dataset Information

Individual risk assessment tool for school-age asthma prediction in UK birth cohort.

ABSTRACT:

Background

Current published asthma predictive tools have moderate positive likelihood ratios (+LR) but high negative likelihood ratios (-LR) based on their recommended cut-offs, which limit their clinical usefulness.

Objective

To develop a simple clinically applicable asthma prediction tool within a population-based birth cohort.

Method

Children from the Manchester Asthma and Allergy Study (MAAS) attended follow-up at ages 3, 8 and 11 years. Data on preschool wheeze were extracted from primary-care records. Parents completed validated respiratory questionnaires. Children were skin prick tested (SPT). Asthma at 8/11 years (school-age) was defined as parentally reported (a) physician-diagnosed asthma and wheeze in the previous 12 months or (b) ≥3 wheeze attacks in the previous 12 months. An asthma prediction tool (MAAS APT) was developed using logistic regression of characteristics at age 3 years to predict school-age asthma.

Results

Of 336 children with physician-confirmed wheeze by age 3 years, 117(35%) had school-age asthma. Logistic regression selected 5 significant risk factors which formed the basis of the MAAS APT: wheeze after exercise; wheeze causing breathlessness; cough on exertion; current eczema and SPT sensitisation(maximum score 5). A total of 281(84%) children had complete data at age 3 years and were used to test the MAAS APT. Children scoring ≥3 were at high risk of having asthma at school-age (PPV > 75%; +LR 6.3, -LR 0.6), whereas children who had a score of 0 had very low risk(PPV 9.3%; LR 0.2).

Conclusion

MAAS APT is a simple asthma prediction tool which could easily be applied in clinical and research settings.

SUBMITTER: Wang R

PROVIDER: S-EPMC6446726 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Individual risk assessment tool for school-age asthma prediction in UK birth cohort.

Wang Ran R Simpson Angela A Custovic Adnan A Foden Phil P Belgrave Danielle D Murray Clare S CS

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 20190104 3

<h4>Background</h4>Current published asthma predictive tools have moderate positive likelihood ratios (+LR) but high negative likelihood ratios (-LR) based on their recommended cut-offs, which limit their clinical usefulness.<h4>Objective</h4>To develop a simple clinically applicable asthma prediction tool within a population-based birth cohort.<h4>Method</h4>Children from the Manchester Asthma and Allergy Study (MAAS) attended follow-up at ages 3, 8 and 11 years. Data on preschool wheeze were e ...[more]

PMID: 30447026

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Project description:BackgroundSpirometric obstruction and restriction are two patterns of impaired lung function which are predictive of poor health. We investigated the development of these phenotypes and their transitions through childhood to early adulthood.MethodsIn this study, we analysed pooled data from three UK population-based birth cohorts established between 1989 and 1995. We applied descriptive statistics, regression modelling and data-driven modelling to data from three population-based birth cohorts with at least three spirometry measures from childhood to adulthood (mid-school: 8-10 years, n = 8404; adolescence: 15-18, n = 5764; and early adulthood: 20-26, n = 4680). Participants were assigned to normal, restrictive, and obstructive spirometry based on adjusted regression residuals. We considered two transitions: from 8-10 to 15-18 and from 15-18 to 20-26 years.FindingsObstructive phenotype was observed in ∼10%, and restrictive in ∼9%. A substantial proportion of children with impaired lung function in school age (between one third in obstructive and a half in restricted phenotype) improved and achieved normal and stable lung function to early adulthood. Of those with normal lung function in school-age, <5% declined to adulthood. Underweight restrictive and obese obstructive participants were less likely to transit to normal. Maternal smoking during pregnancy and current asthma diagnosis increased the risk of persistent obstruction and worsening. Significant associate of worsening in restrictive phenotypes was lower BMI at the first lung function assessment. Data-driven methodologies identified similar risk factors for obstructive and restrictive clusters.InterpretationThe worsening and improvement in obstructive and restrictive spirometry were observed at all ages. Maintaining optimal weight during childhood and reducing maternal smoking during pregnancy may reduce spirometry obstruction and restriction and improve lung function.FundingMRC Grant MR/S025340/1.

Dataset Information

Individual risk assessment tool for school-age asthma prediction in UK birth cohort.

Background

Objective

Method

Results

Conclusion

Publications

Individual risk assessment tool for school-age asthma prediction in UK birth cohort.

Similar Datasets

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