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Clinical Trial
. 2019 Mar;49(3):292-298.
doi: 10.1111/cea.13319. Epub 2019 Jan 4.

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

Ran Wang  1 , Angela Simpson  1 , Adnan Custovic  2 , Phil Foden  1 , Danielle Belgrave  2 , Clare S Murray  1
Affiliations
Clinical Trial

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

Ran Wang et al. Clin Exp Allergy. 2019 Mar.

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.

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Figures

Figure 1
Figure 1
ROC Curve of MAAS APT at age 3 in predicting school‐age asthma
See this image and copyright information in PMC

References

    1. Frank PI, Morris JA, Hazell ML, Linehan MF, Frank TL. Long term prognosis in preschool children with wheeze: Longitudinal postal questionnaire study 1993‐2004. BMJ. 2008;336(7658):1423‐1426. - PMC - PubMed
    1. Kuehni CE, Brooke AM, Silverman M. Prevalence of wheeze during childhood: retrospective and prospective assessment. Eur Resp J. 2000;16:81‐85. - PubMed
    1. Kurukulaaratchy RJ, Matthews S, Arshad SH. Does environment mediate earlier onset of the persistent childhood asthma phenotype? Pediatrics. 2004;113:345‐350. - PubMed
    1. Henderson J, Granell R, Heron J, et al. Association of wheezing phenotypes in the first 6 years of life with atopy, lung function and airway responsiveness in mid‐childhood. Thorax. 2008;63:974‐980. - PMC - PubMed
    1. Martinez FD, Wright AL, Taussig LM Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med 1995;322:133‐138. - PubMed

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