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The transient value of classifying preschool wheeze into episodic viral wheeze and multiple trigger wheeze

A Schultz1, S G Devadason, O E M Savenije

  • 1School of Paediatric and Child Health, University of Western Australia, Perth, WA, Australia. andre.schultz@health.wa.gov.au

Acta Paediatrica (Oslo, Norway : 1992)
|September 22, 2009
PubMed

Insights

Preschool wheeze phenotypes, episodic (viral) or multiple trigger, are often unstable. Classification based on initial questionnaires changed significantly in over half of children within one year.

Area of Science:

  • Pediatric Respiratory Medicine
  • Asthma Phenotyping
  • Clinical Epidemiology

Background:

  • Preschool wheeze is often classified as episodic (viral) or multiple trigger wheeze.
  • Phenotype determination in research typically relies on retrospective questionnaires.

Purpose of the Study:

  • To assess the temporal stability of proposed preschool wheeze phenotypes.
  • To evaluate if episodic (viral) wheeze and multiple trigger wheeze classifications are consistent over time.

Main Methods:

  • 132 children (2-6 years) with doctor-diagnosed asthma were classified into phenotypes.
  • Children were followed quarterly for one year using standardized questionnaires.
  • Phenotype stability was assessed by comparing initial classification with subsequent assessments.

Main Results:

  • Initial retrospective parental report did not predict phenotype throughout the study year.
  • Phenotypic classification remained stable in only 45.9% of children.
  • Phenotypic classification changed in 54.1% of children over the 1-year study period.

Conclusions:

  • Classification of preschool wheeze into episodic (viral) or multiple trigger phenotypes using retrospective questionnaires is likely to be unstable.
  • Significant changes in phenotype classification occur within a 1-year period for a substantial proportion of children.
Abstract

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