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The use of a screening questionnaire to identify children with likely asthma
Insights
Early identification of childhood asthma is crucial. Many children with likely asthma remain undiagnosed, highlighting a gap in healthcare services and the need for better screening methods.
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Public Health
Background:
- Untreated airway inflammation in asthma can lead to irreversible airway remodeling.
- Early identification of children with likely asthma is essential for timely intervention.
- Current diagnostic methods may miss a significant number of pediatric asthma cases.
Purpose of the Study:
- To identify children with undiagnosed likely asthma within general practice populations.
- To assess the prevalence of likely asthma in children not previously recognized by medical services.
- To evaluate the effectiveness of validated scoring systems in detecting potential pediatric asthma cases.
Main Methods:
- A postal questionnaire survey was administered to parents of children in two general practices.
- Two validated scoring systems, based on symptom reporting, were used to identify children with 'likely asthma'.
- Questionnaire data were cross-referenced with practice records to identify children with a recorded asthma diagnosis or medication use.
Main Results:
- Using the first scoring system, 22.5% of children had likely asthma, with 35.1% lacking recorded evidence.
- The second scoring system identified 15.5% with likely asthma, a quarter of whom had no corroborative records.
- Between 3.5% and 8% of children had likely asthma but no documented medical history, depending on the scoring system used.
Conclusions:
- Validated scoring systems can identify children with likely asthma who may be undiagnosed.
- Clinical assessment is necessary for all identified children to confirm asthma and determine treatment needs.
- These findings have significant implications for healthcare resource allocation and pediatric asthma screening programs.
Background:
The theory that airway remodeling and possible fixed asthma may result from failure to treat asthma airway inflammation highlights the importance of the early identification of patients with likely asthma.
Aim:
To identify children with likely asthma whose condition is unknown to the medical services.
Study:
Postal questionnaire survey.
Setting:
Children in two general practice populations in 1999.
Method:
Parents completed the postal questionnaire surveys. Two validated scoring systems were used to identify children with 'likely asthma': first, three or more positive responses to five key questions; second, three or more positive responses to the same five questions and one more severe symptom (e.g. exercise-induced wheeze). Questionnaire responses were linked to practice records to determine those with a recorded diagnosis of asthma (ever) or of inhaled medication (past 12 months).
Results:
Using the first scoring system, 22.5% of children were identified as having likely asthma; more than one-third of these (35.1%) had no corroborative evidence recorded in the practice records. With the second system, 15.5% had likely asthma, a quarter of whom had no corroborative evidence. Depending on the scoring system chosen, between 3.5% and 8% of children in these practices had likely asthma but no corroborative evidence in their records.
Conclusions:
Children identified using either of these scoring systems would require full clinical assessment to determine their need for medical intervention. These findings have implications for the allocation of health care resources.