Wheezing in early life and validating the asthma predictive index
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Date
2014-08-08
Authors
Richelle, Jacqueline
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Abstract
Background: The asthma predictive index (API) and modified versions (mAPI and m2API) have been
used to identify children wheezing in early life who are at risk of developing asthma by school age.
Objectives: To validate the predictive indices in a Canadian population-based sample by comparing
the indices at 3 years of age to physician-diagnosed asthma at 3 years of age.
Methods: Child health questionnaires and clinical assessments were used to determine positive
predictive indices among 416 subjects from the Winnipeg site of a national populated-based birth
cohort. Performance measures of the indices were calculated using binomial distribution and 95%
confidence interval (95% Cl).
Results: The loose API had the highest sensitivity at 66.7% (95% Cl, 44.9-88.4) when compared to
physician-diagnosed asthma, but as the wheezing frequency criterion increased the sensitivity
decreased to 23.5% (3.4-43.7) as observed in the mAPI.
Conclusions: The best asthma predictive index to predict an asthma diagnosis at 3 years of age is the
m2API . However, none of the indices have a high enough sensitivity to support a recommendation for
exclusive use of an index when assessing a child 's risk of asthma. The indices did perform similarly in
the CHILD study compared to findings in the TCRS and COAST study, and in fact the sensitivity and
specificity were slightly higher in the CHILD cohort.
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Keywords
wheezing, asthma predictive index