Validation of a questionnaire against clinical assessment in the diagnosis of asthma in school children

Hansen, Tonje Elisabeth; Evjenth, Bjørg; Holt, Jan

doi:10.3109/02770903.2014.966914

Cited by 21 publications

(19 citation statements)

References 28 publications

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“…However, these questionnaires are bigger and more complex and aimed at detecting these diseases and their risk factors in community settings. 6–9 We identified minimal symptoms (wheeze, breathlessness/cough, and intermittent relief periods) that were sufficient to provide enough accuracy for disease detection. Being short and simple, these questions would be easy to use in busy clinical practice or by trained healthcare workers.…”

Section: Discussionmentioning

confidence: 99%

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Peak flow meter with a questionnaire and mini-spirometer to help detect asthma and COPD in real-life clinical practice: a cross-sectional study

Thorat¹,

Salvi²,

Kodgule³

2017

npj Prim Care Resp Med

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Peak flow meter with questionnaire and mini-spirometer are considered as alternative tools to spirometry for screening of asthma and chronic obstructive pulmonary disease. However, the accuracy of these tools together, in clinical settings for disease diagnosis, has not been studied. Two hundred consecutive patients with respiratory complaints answered a short symptom questionnaire and performed peak expiratory flow measurements, standard spirometry with Koko spirometer and mini-spirometry (COPD-6). Spirometry was repeated after bronchodilation. Physician made a final diagnosis of asthma, chronic obstructive pulmonary disease and others. One eighty nine patients (78 females) with age 51 ± 17 years with asthma (115), chronic obstructive pulmonary disease (33) and others (41) completed the study. “Breathlessness > 6months” and “cough > 6months” were important symptoms to detect obstructive airways disease. “Asymptomatic period > 2 weeks” had the best sensitivity (Sn) and specificity (Sp) to differentiate asthma and chronic obstructive pulmonary disease. A peak expiratory flow of < 80% predicted was the best cut-off to detect airflow limitation (Sn 90%, Sp 50%). Respiratory symptoms with PEF < 80% predicted, had Sn 84 and Sp 93% to detect OAD. COPD-6 device under-estimated FEV1 by 13 mL (95% CI: −212, 185). At a cut-off of 0.75, the FEV1/FEV6 had the best accuracy (Sn 80%, Sp 86%) to detect airflow limitation. Peak flow meter with few symptom questions can be effectively used in clinical practice for objective detection of asthma and chronic obstructive pulmonary disease, in the absence of good quality spirometry. Mini-spirometers are useful in detection of obstructive airways diseases but FEV1 measured is inaccurate.

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Section: Discussionmentioning

confidence: 99%

“…6–9 The sensitivity and specificity reported using these tools ranged between 50 and 96% depending on the criteria used for the diagnosis. The questionnaires for asthma have been tested for assessing prevalence of asthma in the community.…”

Section: Introductionmentioning

confidence: 99%

Peak flow meter with a questionnaire and mini-spirometer to help detect asthma and COPD in real-life clinical practice: a cross-sectional study

Thorat¹,

Salvi²,

Kodgule³

2017

npj Prim Care Resp Med

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“…Prevalences in the KiGGS study in the corresponding “7- to 10-years” age group were based solely on parent information. A Norwegian study found high concordance rates between parent information and medical examinations for allergic diseases, whereby, interestingly, simple questions such as “Does your child suffer from asthma?” exhibited higher validity than those relating to specific asthma symptoms [13]. …”

Section: Discussionmentioning

confidence: 99%

Allergy and school: nothing to be sneezed at!

et al. 2016

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Background:Allergic diseases account for the largest proportion of chronic diseases in childhood and adolescence and place a significant burden on everyday family, social, and in particular school life. Without appropriate education, affected individuals often have little of the knowledge required to understand and deal safely with their allergic disease, and their social environment (school) generally offers insufficient information. An interdisciplinary project involving the Bielefeld Community Foundation (“Bielefelder Bürgerstiftung”), the Children’s Center Bethel, and the local school authority investigated the current knowledge, possibilities for increasing that knowledge, as well as pupils’ and teachers’ perception of the problems experienced by fellow pupils, while at the same time collecting current prevalence figures on allergic diseases among primary school children.Methods:All Bielefeld primary schools were invited to participate in the 3 years between 2008 and 2010. A teaching session on allergic diseases held by specialists from the pediatric hospital formed the core of the project. A standardized survey of children – which also addressed non-affected children for the first time in Germany – on the effects of, their knowledge of, and their attitudes toward allergic diseases, as well as an assessment of their quality of life (cross-sectional study), was conducted prior to and following each session. Parents were also surveyed.Results:In all, 24 schools per year, each with around 60 classes and 1,250 pupils aged 9 years, took part between 2008 and 2010. Approximately 30 % reported suffering from an allergic disease themselves, of which – with regard to single entries – 16 % were “allergies,” 4 % “asthma,” and 5 % atopic dermatitis. Figures collected from parents were only slightly lower than those from their children. Clear deficits that existed in terms of factual knowledge and/or correct conduct in allergic disease – among affected children as well as in their social environment – prior to the education program were noticeably improved by the teaching session.Discussion:The prevalence data gathered here confirm the high numbers recently found in the KiGGS study. Thus, allergic diseases represent a considerable disease risk and potential burden in school children. Providing affected children and their social environment (teachers, fellow pupils) with specialist education can bring about considerable improvements in everyday school life.

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“…The single ISAAC question, parent‐reported physician diagnosed asthma, was used as a proxy for physician diagnosis through clinical assessment . Previous studies found the parent‐reported physician diagnosed asthma question had a high sensitivity (88‐96%) and specificity (87‐96%) in children when compared to physician diagnosis, thus was used as the criterion standard in this study.…”

Section: Methodsmentioning

confidence: 99%

“…Many research studies use the parent‐reported physician diagnosed asthma question developed by the International Study of Allergies and Asthma in Childhood (ISAAC) as a proxy for a clinical assessment . Parent‐reported physician diagnosed asthma has been found to have a high sensitivity (88‐96%) and specificity (87‐96%) when compared to a clinical diagnosis in children …”

Section: Introductionmentioning

confidence: 99%

Agreement between a health claims algorithm and parent‐reported asthma in young children

Omand

Maguire

O'Connor

et al. 2019

Pediatric Pulmonology

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Introduction Asthma prevalence is commonly measured in national surveys by questionnaire. The Ontario Asthma Surveillance Information System (OASIS) developed a validated health claims diagnosis algorithm to estimate asthma prevalence. The primary objective was to assess the agreement between two approaches of measuring asthma in young children. Secondary objectives were to identify concordant and discordant pairs, and to identify factors associated with disagreement. Study design and setting A measurement study to evaluate the agreement between the OASIS algorithm and parent‐reported asthma (criterion standard). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Multivariable logistic regression was used to determine factors associated with disagreement. Results Healthy children aged 1 to 5 years (n =3642) participating in the TARGet Kids! practice based research network 2008‐2013 in Toronto, Canada were included. Prevalence of asthma was 14% and 6% by the OASIS algorithm and parent‐reported asthma, respectively. The Kappa statistic was 0.43, sensitivity 81%, specificity 90%, PPV 34%, and NPV 99%. There were 3249 concordant and 393 discordant pairs. Statistically significant factors associated with asthma identified by OASIS but not parent report included: male sex, higher zBMI, and parent history of asthma. Males were less likely to have asthma identified by parent report but not OASIS. Conclusion The OASIS algorithm identified more asthma cases in young children than parent‐reported asthma. The OASIS algorithm had high sensitivity, specificity, and NPV but low PPV relative to parent‐reported asthma. These findings need replication in other populations.

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Validation of a questionnaire against clinical assessment in the diagnosis of asthma in school children

Abstract: Based on the good agreement between the questionnaire responses and the clinical assessments, it is concluded that the questionnaire had good validity and served as a useful epidemiological tool. Detailed clinical testing added little additional information.

Cited by 21 publications

References 28 publications

Peak flow meter with a questionnaire and mini-spirometer to help detect asthma and COPD in real-life clinical practice: a cross-sectional study

Peak flow meter with a questionnaire and mini-spirometer to help detect asthma and COPD in real-life clinical practice: a cross-sectional study

Allergy and school: nothing to be sneezed at!

Agreement between a health claims algorithm and parent‐reported asthma in young children

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