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Prevalence of wheeze during childhood: retrospective and prospective assessment
C E Kuehni1, A M Brooke, M Silverman
1Dept of Child Health, Leicester University and Leicestershire and Rutland Healthcare Trust, UK.
Insights
A simple question about wheezing in children accurately reflects lifetime asthma prevalence. This retrospective recall method is validated for assessing wheeze history in children aged 8-13 years.
Area of Science:
- Pediatric Respiratory Medicine
- Epidemiology
- Allergy Research
Background:
- Asthma diagnosis in children often relies on symptom reporting.
- Wheezing is a key indicator for asthma and allergies.
- Validating simple proxy measures for prevalence is crucial for public health.
Purpose of the Study:
- To assess the validity of a retrospective question about wheezing as a proxy for lifetime asthma prevalence.
- To compare retrospective recall with prospective assessment in a longitudinal cohort.
- To evaluate the predictive value of wheeze history for current asthma.
Main Methods:
- A population-based cohort of 1,422 children aged 8-13 years was surveyed.
- Standardized questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC) were used.
- Retrospective recall of wheeze was compared with prospective assessment over three surveys.
Main Results:
- The prevalence of current wheeze increased across surveys.
- Reported 'wheeze ever' significantly increased, closely matching prospective lifetime prevalence (39.2% vs. 42.8%).
- The retrospective question demonstrated good negative (97%) and reasonable positive (65%) predictive values.
Conclusions:
- Retrospective recall of wheezing is a valid method for assessing lifetime prevalence in children aged 8-13.
- This simple question serves as a reliable proxy measure for lifetime wheeze.
- Wheeze history is a significant predictor of current asthma status in children.
Abstract:
The question "Has your child ever had wheezing or whistling in the chest at any time in the past?" is a simple and widely used proxy measure for the lifetime prevalence of asthma. Our aim was to test its validity in a longitudinal survey, comparing retrospective recall with prospective assessment of lifetime prevalence. A population-based cohort of 1,422 children, surveyed twice previously, was studied again at age 8-13 yrs by postal questionnaire using standardized questions from the International Study of Asthma and Allergies in Childhood (ISAAC). Of those traced (1,190) questionnaires were returned by 89%. The prevalence of current wheeze was higher than in the previous surveys (20.5% versus 12.4% and 12.5%). Reported "wheeze ever" increased significantly from survey 1 (15.6%) to survey 2 (22.4%) and survey 3 (39.2%) and was very similar to the cumulative lifetime prevalence assessed prospectively over three surveys (42.8%). The retrospective question had a good negative predictive value (97%) and a reasonable positive predictive value (65%) compared to prospective assessment. Children reporting "wheeze ever" (but not current wheeze) in surveys 1 and 2 had at survey 3 an asthma prevalence higher than never-wheezers but lower than current-wheezers. It is concluded that retrospective recall of wheeze at age 8-13 yrs is a valid proxy measure for the lifetime prevalence of wheeze.