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Parents know it best: Prediction of asthma and lung function by parental perception of early wheezing episodes
Tabea Brick1, Alexander Hose1, Katharina Wawretzka1
1Dr von Hauner Children's Hospital, Ludwig Maximilians University of Munich, Munich, Germany.
Insights
Accurate parental recall of early wheeze in children predicts later asthma diagnosis and impaired lung function. This true-positive recall is influenced by wheeze frequency, timing, and parental asthma history.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Genetics
Background:
- Childhood asthma is frequently preceded by early wheeze, but retrospective reporting can introduce recall bias.
- Understanding the accuracy of parent-reported wheeze is crucial for early asthma detection.
Purpose of the Study:
- To assess the true-positive recall of parent-reported wheeze at age 1 year.
- To identify determinants of accurate wheeze recall.
- To investigate the implications of recall accuracy for asthma and lung function at age 6 years.
Main Methods:
- The study followed 880 children from the PASTURE cohort (Protection Against Allergy-Study in Rural Environments) across 5 European countries from birth to age 6.
- Weekly wheeze symptoms were recorded during the first year; asthma diagnosis and lung function were assessed at age 6.
- True-positive recall was evaluated for associations with lung function, asthma, and chromosome 17q21 asthma risk single nucleotide polymorphisms (SNPs).
Main Results:
- Parents accurately recalled wheeze in 54% of cases in the first year.
- Recall accuracy was associated with the number and timing of wheeze episodes, and parental asthma history.
- True-positive recall independently predicted asthma at age 6 (OR 4.54) and impaired lung function (β = -0.62), with stronger associations in children with 17q21 SNPs.
Conclusions:
- Accurate parental recall of early wheezing episodes may signify clinical relevance and predict subsequent asthma and lung function deficits.
- Tailoring questions about perceived wheezing could improve asthma prediction models.
Background:
Childhood asthma is often preceded by early wheeze. Usually, wheezing episodes are recorded retrospectively, which may induce recall bias.
Aims And Objectives:
The aim of this study was to investigate true-positive recall of parent-reported wheeze at 1 year of age, its determinants, and its implications for asthma and lung function at 6 years of age.
Methods:
The PASTURE (Protection Against Allergy-Study in Rural Environments) study followed 880 children from rural areas in 5 European countries from birth to age 6 years. Wheeze symptoms in the first year were asked weekly. At age 6, parent-reported asthma diagnosis was ascertained and lung function measurements were conducted. Correct parental recall of wheeze episodes at the end of the first year was assessed for associations with lung function, asthma, and the asthma risk locus on chromosome 17q21.
Results:
Parents correctly recalled wheeze after the first year in 54% of wheezers. This true-positive recall was determined by number of episodes, timing of the last wheeze episode, and parental asthma. Independently from these determinants, true-positive recall predicted asthma at age 6 years (odds ratio 4.54, 95% confidence interval (CI) [1.75-14.16]) and impaired lung function (β = -0.62, 95% CI [-1.12; -0.13], P-value = .02). Associations were stronger in children with asthma risk SNPs on chromosome 17q21.
Conclusion:
Correct parental recall of wheezing episodes may reflect clinical relevance of early wheeze and its impact on subsequent asthma and lung function impairment. Questions tailored to parental perception of wheezing episodes may further enhance asthma prediction.
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