Distinguishing phenotypes of childhood wheeze and cough using latent class analysis

Abstract

Airway disease in childhood comprises a heterogeneous group of disorders. Attempts to distinguish different phenotypes have generally considered few disease dimensions. The present study examines phenotypes of childhood wheeze and chronic cough, by fitting a statistical model to data representing multiple disease dimensions.From a population-based, longitudinal cohort study of 1,650 preschool children, 319 with parent-reported wheeze or chronic cough were included. Phenotypes were identified by latent class analysis using data on symptoms, skin-prick tests, lung function and airway responsiveness from two preschool surveys. These phenotypes were then compared with respect to outcome at school age.The model distinguished three phenotypes of wheeze and two phenotypes of chronic cough. Subsequent wheeze, chronic cough and inhaler use at school age differed clearly between the five phenotypes. The wheeze phenotypes shared features with previously described entities and partly reconciled discrepancies between existing sets of phenotype labels.This novel, multidimensional approach has the potential to identify clinically relevant phenotypes, not only in paediatric disorders but also in adult obstructive airway diseases, where phenotype definition is an equally important issue.

Early patterns of wheezing in asthmatic and nonasthmatic children

“…However, had all children undergone allergic tests at six years, some non-allergic asthmatics could have been considered as having allergic asthma, as sensitisation to inhalant allergens increases with age. Nevertheless, not too much misclassification seems to have happened as the percentage of asthmatic children with allergic asthma (63.5%) was not lower than the one found in other studies [15,16]. Another limitation of the study is the absence of some data, which may help a more subtle interpretation: family allergy risk, smoke exposure and other risk factors.…”

Characterizing wheeze phenotypes to identify endotypes of childhood asthma, and the implications for future management

“…Identifying groups of symptoms which coexist for different asthma phenotypes will improve diagnosis and identification of patients who respond to treatment. Previous studies have looked at understanding the different dimensions of respiratory diseases [58][59][60][61]. Although these studies are not limited to asthma, they are useful for helping us to distinguish comorbidities of different asthma phenotypes.…”

Patterns of airway disease and the clinical diagnosis of asthma in the Busselton population

“…In an effort to improve phenotype characterisation, statistical analyses of patient populations have been explored [5,13]. This approach has been used in patients diagnosed with asthma or COPD [11,[14][15][16][17].…”