Related Experiment Video
Updated: Apr 30, 2026
A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma
Published on: June 4, 2017
Validating childhood asthma in an epidemiological study using linked electronic patient records
Rosaleen P Cornish1, John Henderson, Andrew W Boyd
1School of Social and Community Medicine, University of Bristol, Bristol, UK.
Insights
Parental reports of a doctor diagnosing asthma are highly accurate, aligning well with general practitioner records. Detailed wheezing questions improve specificity but may miss mild asthma cases.
Area of Science:
- Pediatric respiratory health
- Epidemiological research methods
Background:
- Parent-reported data is often used in epidemiological studies.
- Validating parent-reported data against objective medical records is crucial for accuracy.
Purpose of the Study:
- To assess the performance of parent-reported data in identifying physician-confirmed childhood asthma.
- To compare parent-reported asthma diagnoses with general practitioner (GP) records.
Main Methods:
- A validation study linked the Avon Longitudinal Study of Parents and Children (ALSPAC) with the General Practice Research Database (GPRD).
- Analyzed data from 141 participants with complete parent-reported asthma information.
- Compared parent-reported doctor diagnosis and wheezing history with GP-recorded asthma diagnoses before age nine.
Main Results:
- Parental report of a doctor's asthma diagnosis showed high sensitivity (88.5%) and specificity (95.7%) compared to GP records.
- Questions about wheezing had high sensitivity (100%) but low specificity (60%).
- More specific wheezing criteria improved specificity but reduced sensitivity, potentially missing mild cases.
Conclusions:
- Parental reports of a doctor's asthma diagnosis are a reliable indicator, correlating well with GP-recorded diagnoses.
- Detailed wheezing symptom reporting can enhance asthma diagnosis specificity in research.
- Linking observational studies with electronic patient records improves epidemiological research capabilities.
Objective:
To investigate the performance of parent-reported data in identifying physician-confirmed asthma.
Design And Setting:
Validation study using linkage between the Avon Longitudinal Study of Parents and Children (ALSPAC) and electronic patient records held within the General Practice Research Database (GPRD).
Participants:
Participants were those eligible to participate in ALSPAC who also had a record in the GPRD; this included 765 individuals, just under 4% of ALSPAC-eligible participants. The analysis was based on 141 participants with complete parent-reported asthma data.
Primary And Secondary Outcome Measures:
The main GPRD outcome measure was whether a child had a diagnosis of asthma before they were nine. Parent-reported measures were doctor diagnosis of asthma (before mean age 7.5 years), various outcomes based on wheezing and breathlessness recorded longitudinally between 6 months and 8.5 years. Secondary outcomes were bronchial hyper-responsiveness (BHR), forced expiratory volume in 1 s/forced vital capacity ratio and skin prick test responses.
Results:
Among the 141 participants with complete parent-reported data, 26 (18%) had an asthma diagnosis before age nine. Using general practitioner (GP)-recorded asthma as the gold standard, the question 'Has a doctor ever diagnosed your child with asthma?' was both sensitive (88.5%) and specific (95.7%). 'Ever wheezed' had the highest sensitivity (100%) but low specificity (60%). More specific definitions were obtained by restricting to those who had wheezed on more than one occasion, experienced frequent wheeze and/or wheezed after the age of 3, but these measures had low sensitivities. BHR only identified 50% of those with a GP-recorded diagnosis.
Conclusions:
Parental reports of a doctor's diagnosis agree well with a GP-recorded diagnosis. High specificity for asthma can be achieved by using detailed wheezing questions, although these definitions are likely to exclude mild cases of asthma. Our study shows that linkage between observational studies and electronic patient records has the potential to enhance epidemiological research.
Related Concept Videos
01:29Asthma-I: Introduction
01:28Asthma I: Introduction
01:13Asthma III: Clinical Manifestations
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes: