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Cohort-based development and validation of a nomogram for predicting cough variant asthma progression to typical

Kaiwen Zheng1, Qin Wang2, Yuling Zhao2

  • 1School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|July 18, 2026
PubMed

Insights

Predicting childhood cough variant asthma (CVA) progression to typical asthma (TA) is challenging. A new nomogram identifies key risk factors, offering a visual tool for early risk stratification in pediatric patients.

Area of Science:

  • Pediatric Pulmonology
  • Asthma Research
  • Clinical Prediction Modeling

Background:

  • Cough variant asthma (CVA) often precedes typical asthma (TA) in children, but predicting this progression is clinically difficult.
  • Early identification of children at high risk for CVA to TA progression is crucial for timely intervention.

Purpose of the Study:

  • To identify independent risk factors for the progression of pediatric CVA to TA.
  • To develop and validate a visualized nomogram for early risk stratification of this disease progression.

Main Methods:

  • A prospective cohort of 289 children with CVA was followed for 12 months.
  • Risk factors were screened using logistic regression and LASSO regression.
  • A nomogram was constructed and validated using ROC curves, calibration, and decision curve analysis.

Main Results:

  • 14.5% of children progressed from CVA to TA during follow-up.
  • Ten independent predictors were identified, including personal/family history of allergy/asthma, treatment compliance, pet ownership, FeNO, CaNO, X5%pred, R5%pred, FEF25%pred, and MMEF%pred.
  • The nomogram demonstrated good predictive performance with AUCs of 0.863 (training) and 0.838 (validation).

Conclusions:

  • A novel nomogram integrating ten risk factors provides a preliminary, visually intuitive tool for stratifying the risk of CVA to TA progression in children.
  • This model aids in early identification and management of pediatric asthma.
  • Further validation in diverse populations is warranted.

Keywords:
Cough variant asthmaLASSO regressionchildrennomogramprediction modeltypical asthma

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