A systematic review of asthma case definitions in 67 birth cohort studies

Dubovyi, A. I.; Chelimo, Carol; Schierding, William; Bisyuk, Yuriy; Camargo, Carlos A.; Grant, Cameron

doi:10.1016/j.prrv.2019.12.005

Cited by 7 publications

(5 citation statements)

References 75 publications

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“…Children with a history of asthma diagnosis and recent medication use within the last 12 months from the measurement time were considered as having active asthma. 35 The absence of a significant association between maternal education and active asthma at the age of 9-10 years aligns with a systematic review's conclusion, which reported that the traditional relation between lower SES and higher asthma prevalence is evident until children are age 9 years. 36 Among older children and adolescents, mixed results were reported.…”

Section: Discussionsupporting

confidence: 73%

Early family socioeconomic status and asthma-related outcomes in school-aged children: Results from seven birth cohort studies

Yang-Huang,

McGrath,

Gauvin

et al. 2024

J Epidemiol Community Health

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ObjectiveTo examine the associations between maternal education and household income during early childhood with asthma-related outcomes in children aged 9–12 years in the UK, the Netherlands, Sweden, Australia, the USA and Canada.MethodsData on 31 210 children were obtained from 7 prospective birth cohort studies across six countries. Asthma-related outcomes included ever asthma, wheezing/asthma attacks and medication control for asthma. Relative social inequalities were estimated using pooled risk ratios (RRs) adjusted for potential confounders (child age, sex, mother ethnic background and maternal age) for maternal education and household income. The Slope Index of Inequality (SII) was calculated for each cohort to evaluate absolute social inequalities.ResultsEver asthma prevalence ranged from 8.3% (Netherlands) to 29.1% (Australia). Wheezing/asthma attacks prevalence ranged from 3.9% (Quebec) to 16.8% (USA). Pooled RRs for low (vs high) maternal education and low (vs high) household income were: ever asthma (education 1.24, 95% CI 1.13 to 1.37; income 1.28, 95% CI 1.15 to 1.43), wheezing/asthma attacks (education 1.14, 95% CI 0.97 to 1.35; income 1.22, 95% CI 1.03 to 1.44) and asthma with medication control (education 1.16, 95% CI 0.97 to 1.40; income 1.25, 95% CI 1.01 to 1.55). SIIs supported the lower risk for children with more highly educated mothers and those from higher-income households in most cohorts, with few exceptions.ConclusionsSocial inequalities by household income on the risk of ever asthma, wheezing/asthma attacks, and medication control for asthma were evident; the associations were attenuated for maternal education. These findings support the need for prevention policies to address the relatively high risks of respiratory morbidity in children in families with low socioeconomic status.

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Section: Discussionsupporting

confidence: 73%

Early family socioeconomic status and asthma-related outcomes in school-aged children: Results from seven birth cohort studies

Yang-Huang,

McGrath,

Gauvin

et al. 2024

J Epidemiol Community Health

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“…The definition of asthma has presented wide heterogeneity in cohort studies carried out on infants. 15 Asthma has a broad clinical spectrum, ranging from a minute or even asymptomatic to major and life-threatening forms. Hence, it is considered as a syndrome rather than a disease, in which patients with recurring symptoms caused by variable airway obstruction, such as wheeze, cough, shortness of breath or thoracic oppression that varies over time and in intensity, are grouped together.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of symptoms, severity and diagnosis of asthma in adolescents in the Province of Salamanca, Spain: Global Asthma Network (GAN) Phase I

Cassinello

Vega-Hernández

Lumbreras

et al. 2021

aei

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Introduction and objectives: Asthma is the most prevalent chronic disease in childhood. However, the latest data on its prevalence in Spain are from Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC), 2004. The objective of our study was to assess the prevalence of asthma symptoms, severity and diagnosis in the paediatric popula-tion aged between 13 and 14 years in the province of Salamanca.Material and methods: Cross-sectional multicentre study carried out in 2017–2018 in 13-and 14-year-old school children in the province of Salamanca as a centre participating in of the Global Asthma Network (GAN) Phase I. The standardised validated written question-naire and that directed by a video was administered; it was self-completed by the pupils. Results: A total of 3485 questionnaires were completed, and the pupils’ participation rate was 95.01%. Among the total, 25.7% indicated having had wheeze ever (20.7% in the video questionnaire); 14.7% indicated having had wheeze in the past 12 months (11.3% in the video questionnaire). The prevalence of current wheeze that limited speech was 3.9% (7.5% in the video questionnaire) and the current prevalence of severe wheeze was 6.5%. Regarding asthma diagnosis, 19.7% of the sample answered that they had had asthma ever, whilst 14.0% referred to having physician-diagnosed asthma. The agreement between the written ques-tionnaire and that directed by video was acceptable for the questions of wheeze ever (Cohen Kappa index [k] = 0.53) and current wheeze (k = 0.42).

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“…Nonetheless, the apparent limitation of our study arises from the definition of asthma. Our principal questionnaire-based outcome was asthma under current treatment, the item frequently used in epidemiological studies [ 39 ]. However, without clinical assessment, the accuracy of any questionnaire-based definition of asthma remains unknown [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Screening Accuracy of FeNO Measurement for Childhood Asthma in a Community Setting

Barański

Zejda

2022

Children

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(1) Background: The exhaled fractional nitric oxide is a well-recognized biomarker used in clinical settings for controlling and managing asthma. Less is known about the value of Fractional Exhaled Nitric Oxide (FeNO) measurement in epidemiological studies on childhood asthma, although available evidence suggests that an increased FeNO is associated with an increased risk of asthma. (2) Aim: The aim of the study was to assess FeNO accuracy in the identification of children with asthma, participants in a population-based respiratory survey. (3) Material and methods: The cross-sectional study included 449 children, 224 (49.9%) boys and 225 (50.1%) girls aged 6–10 years. The FeNO was measured in 449 children; Spirometry tests were completed with 441 children, but technically acceptable spirometry was done in 350. All participants fulfilled the questionnaire (ISAAC) for assessment of the status of their respiratory system on which diagnosis was based on. FeNO and Spirometry were performed according to ERS/ATS recommendations. (4) Results: The FeNO was significantly higher in asthmatic children (n = 22): 27.3 ± 21.3 ppb; with allergic rhinitis (n = 106): 9.9 ± 21.6 ppb, with atopic dermatitis (n = 67) 20.8 ± 25.0 ppb, with an asthmatic tendency (n = 27): 19.8 ± 16.0 ppb in comparison to children without any respiratory/atopy symptoms. The highest diagnostic odds ratio and area under the curve were found in any treated asthma or asthma without any atopic symptoms in relation to FeNO cutoff > 35 ppb; DOR 4.85 and 8.37; AUC 0.615 and 0.795, respectively. The adjustment for spirometry parameters did not improve the diagnostic accuracy of FeNO. In each FeNO cutoff, there were more false positive than true positive subjects. (5) Conclusions. The best diagnostic accuracy of FeNO was for isolated asthma without any atopy against children without any coexisting respiratory or allergic disease. The sensitivity and specificity did not reach the required values for a good screening tool; therefore, it should not be used in epidemiological settings.

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A systematic review of asthma case definitions in 67 birth cohort studies

Cited by 7 publications

References 75 publications

Early family socioeconomic status and asthma-related outcomes in school-aged children: Results from seven birth cohort studies

Early family socioeconomic status and asthma-related outcomes in school-aged children: Results from seven birth cohort studies

Prevalence of symptoms, severity and diagnosis of asthma in adolescents in the Province of Salamanca, Spain: Global Asthma Network (GAN) Phase I

Screening Accuracy of FeNO Measurement for Childhood Asthma in a Community Setting

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