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. 2001 Feb;51(463):112–116.

Childhood asthma: can computers aid detection in general practice?

S Kable 1, R Henry 1, R Sanson-Fisher 1, M Ireland 1, R Corkrey 1, J Cockburn 1
PMCID: PMC1313924  PMID: 11217622

Abstract

BACKGROUND: Childhood asthma remains underdiagnosed in general practice. Computers with a patient interface have the potential to screen children for asthma in a time-efficient manner. AIM: To develop a concise, validated self-report measure that calculates an 'asthma score' that predicts likelihood of asthma and its severity in childhood. DESIGN OF STUDY: Computerised questionnaire survey in general practitioners' (GPs') waiting rooms, followed by a written questionnaire and either bronchial challenge or skin allergy testing at the regional teaching hospital. SETTING: Children between 18 months and 18 years old accompanied by a parent or guardian in five group practices in Newcastle in New South Wales, Australia. METHOD: The responses from both the computerised questionnaire and the written questionnaire were compared with physician assessment of asthma, based on an existing validated questionnaire and clinical tests. RESULTS: Six items were identified to be independently and significantly associated (at P < 0.05) with the presence of asthma and its severity: parent or self-reported asthma, previous diagnosis, wheeze in the past year, physical activity affected by symptoms, night cough in the past year, and visits to a GP in the past year. From the regression model a linear score was derived that indicates whether a child is likely to have asthma and its likely severity. CONCLUSIONS: The asthma score is a valid indicator of asthma and its severity in children in general practice.

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Selected References

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  1. Araki H., Sly P. D. Inhalation of hypertonic saline as a bronchial challenge in children with mild asthma and normal children. J Allergy Clin Immunol. 1989 Jul;84(1):99–107. doi: 10.1016/0091-6749(89)90183-8. [DOI] [PubMed] [Google Scholar]
  2. Asher M. I., Pattemore P. K., Harrison A. C., Mitchell E. A., Rea H. H., Stewart A. W., Woolcock A. J. International comparison of the prevalence of asthma symptoms and bronchial hyperresponsiveness. Am Rev Respir Dis. 1988 Sep;138(3):524–529. doi: 10.1164/ajrccm/138.3.524. [DOI] [PubMed] [Google Scholar]
  3. Burney P. G., Laitinen L. A., Perdrizet S., Huckauf H., Tattersfield A. E., Chinn S., Poisson N., Heeren A., Britton J. R., Jones T. Validity and repeatability of the IUATLD (1984) Bronchial Symptoms Questionnaire: an international comparison. Eur Respir J. 1989 Nov;2(10):940–945. [PubMed] [Google Scholar]
  4. Burney P., Chinn S. Developing a new questionnaire for measuring the prevalence and distribution of asthma. Chest. 1987 Jun;91(6 Suppl):79S–83S. doi: 10.1378/chest.91.6_supplement.79s. [DOI] [PubMed] [Google Scholar]
  5. Burr M. L. Diagnosing asthma by questionnaire in epidemiological surveys. Clin Exp Allergy. 1992 May;22(5):509–510. doi: 10.1111/j.1365-2222.1992.tb00158.x. [DOI] [PubMed] [Google Scholar]
  6. Carleton R. A. Dichotomous disservice? Ann Intern Med. 1997 Apr 1;126(7):589–591. doi: 10.7326/0003-4819-126-7-199704010-00031. [DOI] [PubMed] [Google Scholar]
  7. Charlton I., Jones K., Bain J. Delay in diagnosis of childhood asthma and its influence on respiratory consultation rates. Arch Dis Child. 1991 May;66(5):633–635. doi: 10.1136/adc.66.5.633. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Crain E. F., Weiss K. B., Bijur P. E., Hersh M., Westbrook L., Stein R. E. An estimate of the prevalence of asthma and wheezing among inner-city children. Pediatrics. 1994 Sep;94(3):356–362. [PubMed] [Google Scholar]
  9. Cuijpers C. E., Wesseling G. J., Swaen G. M., Sturmans F., Wouters E. F. Asthma-related symptoms and lung function in primary school children. J Asthma. 1994;31(4):301–312. doi: 10.3109/02770909409089477. [DOI] [PubMed] [Google Scholar]
  10. Frank T. L., Frank P. I., McNamee R., Wright T., Hannaford P., Morrison J., Hirsch S., Pickering C. A. Assessment of a simple scoring system applied to a screening questionnaire of asthma in children aged 5-15 yrs. Eur Respir J. 1999 Nov;14(5):1190–1197. doi: 10.1183/09031936.99.14511909. [DOI] [PubMed] [Google Scholar]
  11. Jenkins M. A., Clarke J. R., Carlin J. B., Robertson C. F., Hopper J. L., Dalton M. F., Holst D. P., Choi K., Giles G. G. Validation of questionnaire and bronchial hyperresponsiveness against respiratory physician assessment in the diagnosis of asthma. Int J Epidemiol. 1996 Jun;25(3):609–616. doi: 10.1093/ije/25.3.609. [DOI] [PubMed] [Google Scholar]
  12. Jones A., Sykes A. The effect of symptom presentation on delay in asthma diagnosis in children in a general practice. Respir Med. 1990 Mar;84(2):139–142. doi: 10.1016/s0954-6111(08)80017-0. [DOI] [PubMed] [Google Scholar]
  13. Joseph C. L., Foxman B., Leickly F. E., Peterson E., Ownby D. Prevalence of possible undiagnosed asthma and associated morbidity among urban schoolchildren. J Pediatr. 1996 Nov;129(5):735–742. doi: 10.1016/s0022-3476(96)70158-0. [DOI] [PubMed] [Google Scholar]
  14. Kaur B., Anderson H. R., Austin J., Burr M., Harkins L. S., Strachan D. P., Warner J. O. Prevalence of asthma symptoms, diagnosis, and treatment in 12-14 year old children across Great Britain (international study of asthma and allergies in childhood, ISAAC UK) BMJ. 1998 Jan 10;316(7125):118–124. doi: 10.1136/bmj.316.7125.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Linna O. Spirometry, bronchodilator test or symptom scoring for the assessment of childhood asthma. Acta Paediatr. 1996 May;85(5):564–569. doi: 10.1111/j.1651-2227.1996.tb14087.x. [DOI] [PubMed] [Google Scholar]
  16. Martinez F. D., Wright A. L., Taussig L. M., Holberg C. J., Halonen M., Morgan W. J. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995 Jan 19;332(3):133–138. doi: 10.1056/NEJM199501193320301. [DOI] [PubMed] [Google Scholar]
  17. Pattemore P. K., Asher M. I., Harrison A. C., Mitchell E. A., Rea H. H., Stewart A. W. The interrelationship among bronchial hyperresponsiveness, the diagnosis of asthma, and asthma symptoms. Am Rev Respir Dis. 1990 Sep;142(3):549–554. doi: 10.1164/ajrccm/142.3.549. [DOI] [PubMed] [Google Scholar]
  18. Pearce N., Weiland S., Keil U., Langridge P., Anderson H. R., Strachan D., Bauman A., Young L., Gluyas P., Ruffin D. Self-reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol. Eur Respir J. 1993 Nov;6(10):1455–1461. [PubMed] [Google Scholar]
  19. Riedler J., Reade T., Dalton M., Holst D., Robertson C. Hypertonic saline challenge in an epidemiologic survey of asthma in children. Am J Respir Crit Care Med. 1994 Dec;150(6 Pt 1):1632–1639. doi: 10.1164/ajrccm.150.6.7952626. [DOI] [PubMed] [Google Scholar]
  20. Robertson C. F., Dalton M. F., Peat J. K., Haby M. M., Bauman A., Kennedy J. D., Landau L. I. Asthma and other atopic diseases in Australian children. Australian arm of the International Study of Asthma and Allergy in Childhood. Med J Aust. 1998 May 4;168(9):434–438. [PubMed] [Google Scholar]
  21. Siersted H. C., Boldsen J., Hansen H. S., Mostgaard G., Hyldebrandt N. Population based study of risk factors for underdiagnosis of asthma in adolescence: Odense schoolchild study. BMJ. 1998 Feb 28;316(7132):651–656. [PMC free article] [PubMed] [Google Scholar]
  22. Siersted H. C. Commentary: improving the diagnostic rate in asthma: a community issue. BMJ. 1998 Feb 28;316(7132):657–657. [PubMed] [Google Scholar]
  23. Song C. H. Skin sensitization in asthmatic children less than 36 months of age. Ann Allergy Asthma Immunol. 1997 Sep;79(3):273–276. doi: 10.1016/S1081-1206(10)63014-1. [DOI] [PubMed] [Google Scholar]
  24. Steen N., Hutchinson A., McColl E., Eccles M. P., Hewison J., Meadows K. A., Blades S. M., Fowler P. Development of a symptom based outcome measure for asthma. BMJ. 1994 Oct 22;309(6961):1065–1068. doi: 10.1136/bmj.309.6961.1065. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Toop L. J. Active approach to recognising asthma in general practice. Br Med J (Clin Res Ed) 1985 Jun 1;290(6482):1629–1631. doi: 10.1136/bmj.290.6482.1629. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Torén K., Brisman J., Järvholm B. Asthma and asthma-like symptoms in adults assessed by questionnaires. A literature review. Chest. 1993 Aug;104(2):600–608. doi: 10.1378/chest.104.2.600. [DOI] [PubMed] [Google Scholar]
  27. Tse M., Cooper C., Bridges-Webb C., Bauman A. Asthma in general practice. Opportunities for recognition and management. Aust Fam Physician. 1993 May;22(5):736–741. [PubMed] [Google Scholar]
  28. Wolf R. L., Berry C. A., O'Connor T., Coover L. Validation of the Brief Pediatric Asthma Screen. Chest. 1999 Oct;116(4 Suppl 1):224S–228S. doi: 10.1378/chest.116.suppl_2.224s. [DOI] [PubMed] [Google Scholar]

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