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Published on: August 7, 2017
A comparison of childhood asthma case definitions based on parent-reported data
Ruth J Geller1, Janice A Espinola1, Ronaldo C Fabiano Filho1
1Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
Insights
Parent reports of childhood asthma diagnoses align well with established risk factors. This study compared various asthma definitions using parent-reported data, finding specific definitions most accurately predicted asthma outcomes.
Area of Science:
- Pediatric Respiratory Medicine
- Epidemiology
- Clinical Research Methodology
Background:
- Childhood asthma diagnosis relies on various criteria, impacting research accuracy.
- Parental reporting is a key data source in pediatric health studies.
- Standardizing asthma definitions is crucial for reliable research.
Purpose of the Study:
- To compare different research definitions of childhood asthma.
- To evaluate definitions based on parent-reported data.
- To assess the correlation between parent-reported asthma and known risk factors.
Main Methods:
- A prospective cohort study involving 921 infants hospitalized for bronchiolitis.
- Development of four asthma definitions using parent-reported data (broad, epidemiologic, strict, flexible).
- Evaluation of definitions against asthma risk factors and medical records.
Main Results:
- Asthma prevalence varied by definition: broad (34%), epidemiologic (27%), strict (27%), and flexible (44%).
- Definitions requiring clinician diagnosis showed stronger associations with risk factors.
- Epidemiologic and strict definitions demonstrated high specificity (96%) and positive predictive value (92%).
Conclusions:
- Parental reports of clinician-diagnosed asthma correlate strongly with established risk factors.
- Specific, criteria-based definitions offer greater accuracy in identifying childhood asthma.
- Validated parent-reported data can reliably support asthma research.
Purpose:
The purpose of this study was to compare research definitions of childhood asthma based on parent-reported data.
Methods:
We conducted a multicenter, prospective cohort study of 921 infants hospitalized for bronchiolitis. Follow-up was conducted via biannual parent interviews. Asthma definitions were developed using parent-reported data: clinician diagnosis by the age of 5 years ("broad definition"), clinician diagnosis by the age of 5 years with either asthma medication use or asthma symptoms during the age of 4-4.9 years ("epidemiologic definition"), clinician diagnosis by the age of 5 years with either long-term inhaled corticosteroid use or asthma symptoms during the age of 4-4.9 years ("strict definition"), and a "flexible definition" met by any two of the three criteria in the epidemiologic definition. Asthma outcome definitions were evaluated using unadjusted associations with known major asthma risk factors and validated against the medical record in a subset (n = 116).
Results:
Asthma prevalence for the broad definition was 294 of 875 (34%); epidemiologic definition, 235 of 859 (27%); strict definition, 229 of 859 (27%); and flexible definition, 364 of 826 (44%). Risk factors had similarly strong associations with definitions that required clinician diagnosis and weaker associations with the flexible definition. The epidemiologic and strict definitions had the highest specificity (96%) and positive predictive value (92%).
Conclusions:
The parent report of clinician-diagnosed asthma correlates well with known asthma risk factors.
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