edoc

Clinical and epidemiologic phenotypes of childhood asthma

Depner, Martin and Fuchs, Oliver and Genuneit, Jon and Karvonen, Anne M. and Hyvärinen, Anne and Kaulek, Vincent and Roduit, Caroline and Weber, Juliane and Schaub, Bianca and Lauener, Roger and Kabesch, Michael and Pfefferle, Petra Ina and Frey, Urs and Pekkanen, Juha and Dalphin, Jean-Charles and Riedler, Josef and Braun-Fahrländer, Charlotte and von Mutius, Erika and Ege, Markus J. and Pasture Study Group, . (2014) Clinical and epidemiologic phenotypes of childhood asthma. American journal of respiratory and critical care medicine, Vol. 189, H. 2. pp. 129-138.

Full text not available from this repository.

Official URL: http://edoc.unibas.ch/dok/A6233625

Downloads: Statistics Overview

Abstract

Rationale: Clinical and epidemiologic approaches have identified two distinct sets of classifications for asthma and wheeze phenotypes. Objectives: To compare epidemiologic phenotype definitions identified by latent class analysis (LCA) with clinical phenotypes based on patient histories, diagnostic work-up, and treatment responses. To relate phenotypes to genetic and environmental determinants as well as diagnostic and treatment-related parameters. Methods: LCA was performed in an international multicenter birth cohort based on yearly questions about current wheeze until age 6 years. Associations of wheeze classes and clinical phenotypes with asthma-related characteristics such as atopy, lung function, fraction of exhaled nitric oxide, and medication use were calculated using regression models. Measurements and Main Results: LCA identified five classes, which verified the clinically defined wheeze phenotypes with high sensitivity and specificity; the respective receiver operating characteristics curves displayed an area under the curve ranging from 84% (frequent wheeze) to 85% (asthma diagnosis) and 87% (unremitting wheeze) to 97% (recurrent unremitting wheeze). Recurrent unremitting wheeze was the most specific and unremitting wheeze at least once the most sensitive definition. The latter identified a subgroup of children with decreased lung function, increased genetic risk, and in utero smoke exposure (odds ratio, 2.03; 95% confidence interval, 1.12-3.68; P = 0.0191), but without established asthma diagnosis and treatment. Conclusions: Clinical phenotypes were well supported by LCA analysis. The hypothesis-free LCA phenotypes were a useful reference for comparing clinical phenotypes. Thereby, we identified children with clinically conspicuous but undiagnosed disease. Because of their high area under the curve values, clinical phenotypes such as (recurrent) unremitting wheeze emerged as promising alternative asthma definitions for epidemiologic studies.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Microbial Exposure & Childhood Allergies (Braun-Fahrländer)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Braun-Fahrländer, Charlotte
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:HighWire Press
ISSN:0003-0805
Note:Publication type according to Uni Basel Research Database: Journal article
Related URLs:
Identification Number:
Last Modified:18 Jul 2014 09:10
Deposited On:18 Jul 2014 09:10

Repository Staff Only: item control page