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Which is the Optimum Predictor of Childhood Asthma, Persistent Wheezing or the Asthma Predictive Index?

Amin, Priyal

Abstract Details

2014, MS, University of Cincinnati, Medicine: Clinical and Translational Research.

Background: The Asthma Predictive Index (API) and persistent wheezing phenotype have been associated with childhood asthma. Previous studies have not assessed their ability to predict objectively confirmed asthma.

Objective: The aim of this study is to determine whether the API and persistent wheezing phenotype at age three can accurately predict asthma confirmed at age seven in a high risk birth cohort.

Methods: Data from the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), a high risk prospective birth cohort, was used. Asthma was defined as: parent-reported or physician-diagnosed asthma objectively confirmed by a change in FEV1 of = 12% post bronchodilator or a positive methacholine challenge (PC20 = 4 mg/ml); or prior treatment with daily asthma controller medication(s). The API and persistent wheezing were assessed at age three. Multivariate logistic regression was used to investigate the relationship between confirmed asthma at age seven and API and persistent wheezing at age three with adjustment for multiple covariates.

Results: At age seven, 103 of 589 (17.5%) children satisfied the criteria for asthma. Confirmed asthma at age seven was significantly associated with a positive API (adjusted [a]OR=13.3; 95% CI [7.0-25.2]; p <0.01) and the persistent wheezing phenotype (aOR = 9.8 [4.9-19.5]; p <0.01) at age three. Allergic persistent wheezing was associated with a significantly higher risk of asthma (aOR = 10.4 [4.1-26.0]; p <0.01) than non-allergic persistent wheezing (aOR = 5.4 [2.04-14.06]; p <0.01).

Conclusions & Clinical Relevance: At age three a positive API was associated with the highest risk of objectively confirmed asthma at age seven. These results validate the API as a clinically useful tool for predicting future asthma in school-age children.

Erin Nicole Haynes, Ph.D. (Committee Chair)
David Bernstein, M.D. (Committee Member)
Linda Levin, Ph.D. (Committee Member)
Patrick Ryan, Ph.D. (Committee Member)
18 p.

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Citations

  • Amin, P. (2014). Which is the Optimum Predictor of Childhood Asthma, Persistent Wheezing or the Asthma Predictive Index? [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1396531716

    APA Style (7th edition)

  • Amin, Priyal. Which is the Optimum Predictor of Childhood Asthma, Persistent Wheezing or the Asthma Predictive Index? 2014. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1396531716.

    MLA Style (8th edition)

  • Amin, Priyal. "Which is the Optimum Predictor of Childhood Asthma, Persistent Wheezing or the Asthma Predictive Index?" Master's thesis, University of Cincinnati, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1396531716

    Chicago Manual of Style (17th edition)