A Multi-stage asthma Screening Procedure for Elementary School Children†

Gerald, Lynn B.; Redden, David T.; Turner-Henson, Anne; Feinstein, Ronald; Hemstreet, Mary Pat; Hains, Coralie S.; Brooks, C. Michael; Erwin, Sue; Bailey, William C.

doi:10.1081/jas-120000804

Cited by 36 publications

(43 citation statements)

References 27 publications

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“…All newly identified children with asthma aged [7][8][9][10][11] years and their parents were involved in HRQOL study. A disease-specific quality-oflife questionnaire was used for the children and a generic questionnaire for parents.…”

Section: Methodsmentioning

confidence: 99%

Quality of life protocol in the early asthma diagnosis in children

Farnik

Pierzchała

Brożek

et al. 2010

Pediatric Pulmonology

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IntroductionAsthma is considered an important problem in children and influences on their everyday functioning. This study was concerned with the impact of asthma on the health‐related quality of life (HRQOL) of newly recognized pediatric asthma patients and their parents.MethodsPatients were identified by a general respiratory survey. HRQOL was assessed by self‐report measures: disease‐specific questionnaire for children, the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and generic for parents—the Quality of Life in Child's Chronic Disease Questionnaire (QLCCDQ).ResultsTwenty‐nine newly diagnosed asthmatic children aged 7–11 years (mean age = 8.6; SD = 1.4) were identified from a population‐based respiratory health survey. The most impaired HRQOL domains differed in parents and children. In children, activity limitation was the most impaired; however in parents, emotional functioning and symptom perception domains were most impaired. There were no statistically significant differences in patient and parental HRQOL observed in either the group where symptoms were present or in the group were symptoms were not present. Baseline spirometry showed correlation for FEV1%FVC and PAQLQ symptom domain (r = 0.42). Exercise test showed correlations between FEV1%FVC and QLCCDQ emotional domain (r = 0.7); MEF 25–75% and family roles (r = 0.81), as well as social functioning (r = 0.81). Activity limitation on the PAQLQ correlated with the MEF 25–75% (r = 0.44) and PEF (r = 0.55).ConclusionsHRQOL newly recognized children with asthma and their parents does not correlate closely with clinical status. Patient and parental HRQOL should be considered as independent dimensions. Pediatr Pulmonol. 2010;45:1095–1102. © 2010 Wiley‐Liss, Inc.

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Section: Methodsmentioning

confidence: 99%

Quality of life protocol in the early asthma diagnosis in children

Farnik

Pierzchała

Brożek

et al. 2010

Pediatric Pulmonology

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“…18 Previous response and participation rates indicated that the current population would yield 215 students classified as positive for asthma and 2561 students classified as negative for asthma. Assuming that no more than 25% of the 215 students classified as positive for asthma and no more than 10% of a stratified random sample of 240 of the 2561 no-asthma students were misclassified, we would estimate the sensitivity of the procedure with a 95% confidence interval (margin of error no greater than .032) for the best case (sensitivity: Ն95%) or 0.072 for the worst case (sensitivity: 50%).…”

Section: Sample-size Calculationsmentioning

confidence: 99%

“…Therefore, we developed and used a multistage procedure with questionnaires, spirometry, and exercise testing. 18,24 This article reports on a study designed to determine the validity of the University of Alabama at Birmingham (UAB) multistage case-detection procedure.…”

mentioning

confidence: 99%

“…13,[15][16][17] In addition, the school setting can be used to implement therapeutic and educational interventions for students. Case detection and educational interventions are generally well received by school personnel and can identify children with unrecognized or undiagnosed disease, 18,19 as well as those with a current diagnosis but poorly controlled disease.…”

mentioning

confidence: 99%

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Validation of a Multistage Asthma Case-Detection Procedure for Elementary School Children

Gerald

Grad²,

Turner-Henson³

et al. 2004

Pediatrics

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ABSTRACT. Objective. The purpose of this study was to validate a 3-stage asthma case-detection procedure for elementary school-aged children.Methods. The study was performed in 10 elementary schools in 4 inner-city school systems, with a total enrollment of 3539 children. Results of the case-detection procedure were compared with the diagnosis of an asthma specialist study physician, to determine the sensitivity and specificity of the case-detection procedure.Results. Ninety-eight percent of children returned the asthma symptoms questionnaires, and 79% of those children consented to additional testing. Results indicated that the 3-stage procedure had good validity, with sensitivity, specificity, and predictive value of 82%, 93%, and 93%, respectively. A 2-stage procedure using questionnaires and spirometry had similar validity, with sensitivity, specificity, and predictive value of 78%, 93%, and 93%, respectively. However, given the time and expense associated with the 2-or 3-stage procedure and the difficulty of obtaining physician follow-up evaluation of the case-detection diagnosis, schools may prefer to use a 2-item questionnaire that has a lower sensitivity (66%) but higher specificity (96%) and predictive value (95%).Conclusions. Case-detection programs are generally well received by school personnel and can identify children with unrecognized or undiagnosed disease, as well as those with a current diagnosis but poorly controlled disease. This study yields substantial information regarding the validity, yield, and specific types of children who might be identified with the use of such procedures. For the choice of the method of case detection used in a school, the strengths and weaknesses of each procedure, as well as the resources available for case detection, physician referral, and follow-up procedures, must be considered.

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“…Interpretation was based on reference values established by Dockery and Hsu [17,18]. The submaximal exercise challenge step test was completed according to the protocol described by Gerald et al [19,20]. Briefly, the child stepped up and down on a single step maintaining a heart rate between 150-200 beats per minute for five minutes.…”

Section: Clinical Assessmentmentioning

confidence: 99%

Underdiagnosis of childhood asthma: A comparison of survey estimates to clinical evaluation

Brożek¹,

Farnik²,

Lawson³

et al. 2013

International Journal of Occupational Medicine and Environmental Health

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Objectives: Diagnostic patterns play a role in asthma prevalence estimates and could have implications for disease management. We sought to determine the extent to which questionnaire-derived estimates of childhood asthma reflect the disease's true occurrence. Materials and Methods: Children aged 6-12 years from Katowice, Poland, were recruited from a crosssectional survey (N = 1822) via primary schools. Students were categorized into three mutually exclusive groups based on survey responses: "Asthma" (previously diagnosed asthma); "Respiratory symptoms" (no previous diagnosis of asthma and one or more respiratory symptoms during last year), "No respiratory symptoms" (no previous diagnosis of asthma or respiratory symptoms). A sample of children from each group (total N = 456) completed clinical testing to determine asthma presence according to GINA recommendations. Results: Based on the survey, 5.4% of children were classified with asthma, 27.9% with respiratory symptoms, and 66.7% with no respiratory symptoms or asthma. All previously known 41 cases of asthma were confirmed. New diagnoses of asthma were made in 21 (10.9%) and 8 (3.6%) of subjects from the "Respiratory symptoms" (N = 192) and "No respiratory symptoms" (N = 223) groups, respectively. The overall prevalence of childhood asthma, incorporating the results of clinical examination, was 10.8% (95% CI: 9.4-12.2), compared to the questionnairederived figure of 5.4% (95% CI: 4.4-6.5%) and affected females more than males. Conclusions: Asthma prevalence was underestimated in this population possibly resulting from under-presentation or under-diagnosis. This could have potential implications for proper management and well-being of children. Questionnaire estimates of prevalence should be considered carefully in the context of regional diagnostic patterns.

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A Multi-stage asthma Screening Procedure for Elementary School Children†

Cited by 36 publications

References 27 publications

Quality of life protocol in the early asthma diagnosis in children

Quality of life protocol in the early asthma diagnosis in children

Validation of a Multistage Asthma Case-Detection Procedure for Elementary School Children

Underdiagnosis of childhood asthma: A comparison of survey estimates to clinical evaluation

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