The International Study of Wheezing in Infants: Questionnaire Validation

Abstract

Background: There are no internationally validated questionnaires to investigate the prevalence of infant wheezing. This study was undertaken to validate a questionnaire for the International Study on the Prevalence of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). Material and Methods: Construct and criterion validity were tested for the question ‘Has your baby had wheezing or whistling in the chest during his/her first 12 months of life?’. Construct validity (i.e. the ability of parents and doctors to refer to the same symptoms with the same words) was tested in a sample of 50 wheezing and 50 non-wheezy infants 12–15 months of age in each of 10 centres from 6 different Spanish- or Portuguese-speaking countries. Criterion validity (i.e. the ability of parents to correctly detect the symptom in the general population) was evaluated in 2 samples (Santiago, Chile and Cartagena, Spain) of 50 wheezing and 50 non-wheezing infants (according to parents) of the same age, randomly selected from the general population, who were later blindly diagnosed by a paediatric pulmonologist. Results: Construct validity was very high (ĸ test: 0.98–1) in all centres. According to Youden’s index, criterion validity was good both in Cartagena (75.5%) and in Santiago (67.0%). Adding questions about asthma medication did not improve diagnosis accuracy. Conclusions: The EISL questionnaire significantly distinguished wheezy infants from healthy ones. This questionnaire has a strong validity and can be employed in large international multicentre studies on wheezing during infancy.

Prevalência de sibilância e fatores de risco associados em crianças no primeiro ano de vida, residentes no Município de Recife, Pernambuco, Brasil

“…As infecções respiratórias virais são comuns na infância e também têm sido implicadas no desencadeamento de quadros de sibilância nos primeiros anos de vida e persistência de sintomas nos primeiros dez anos de idade 16,33 . Resultados do Tucson Children's Respiratory Study demonstraram que o vírus respiratório sincicial acomete a maioria das crianças menores de dois anos, e que se associa a quadros de sibilância persistente que desaparece aos 13 anos 25 .…”

“…Esta pesquisa foi realizada segundo o protocolo do Estudio Internacional de Sibilancia en Lactantes (EISL) 16 . Pais e/ou responsáveis por crianças com idades entre 12 e 15 meses de vida e em bom estado geral de saúde responderam ao questionário escrito (QE) padronizado (QE-EISL) durante o seu atendimento em postos de saúde da cidade de Recife, quando realizavam consultas e/ou imunizações de rotina.…”

Wheezing in infancy: epidemiology, investigation, and treatment

“…O instrumento padronizado já foi validado para as línguas portuguesa e espanhola, com possibilidade de ser aplicado aos pais de crianças de até 36 meses de vida e capaz de identificar com boa precisão os lactentes que sofrem de sibilância no primeiro ano de idade, seja ela recorrente ou não, identificando suas características clínicas, fatores de risco e tratamento [31][32][33][34] .…”

Sibilância no lactente: epidemiologia, investigação e tratamento

“…29,30 The standardized instrument has already been validated for the Portuguese and Spanish languages, can be administered to the parents of children aged up to 36 months, is capable of identifying infants who wheeze during the first year of life, whether recurrently or not, with a good level of precision, and identifies these children's clinical characteristics, risk factors and treatments. [31][32][33][34] In common with the results of the International Study of Asthma and Allergies in Childhood (ISAAC), the prevalence of wheezing among infants has exhibited great variation in the few cohort studies that have been published. 1,[5][6][7][8][9] Cohort studies are difficult to conduct because they require greater commitment from infants' parents/guardians, which opens the door to the possibility of losing them to longterm follow-up.…”