A School-Based Case Identification Process for Identifying Inner City Children With Asthma

Jones, Craig; Morphew, Tricia; Clement, Loran T.; Kimia, T.; Dyer, Marc; Li, Marilyn; Hanley-Lopez, Jean

doi:10.1378/chest.125.3.924

Cited by 56 publications

(53 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A large-scale school screening effort underway in Orange County uses scanning software and case-detection criteria developed and validated in Los Angeles County by Jones et al 28 Validation of this comprehensive (complete) algorithm, which considers previously diagnosed cases and potential undiagnosed cases with symptom experience indicative of asthma, was examined in our study population. Briefly, the scanning software generates 1 of 3 letters for each child, on the basis of prior diagnosis and probability of asthma.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…[24][25][26] A growing number of studies with different validation methods have been performed with pediatric populations. 7,14,20,24,25,[27][28][29][30][31] Although potentially useful, several have methodologic problems (Table 1). Few randomly selected subjects from the community for validation, 27 and only some used validation by an asthma specialist.…”

mentioning

confidence: 99%

“…Few randomly selected subjects from the community for validation, 27 and only some used validation by an asthma specialist. 7,16,20,24,28 Although several were school-based, few questionnaires examined innercity populations. 20,27,28,30 Only 2 studies were crosscultural (ie, simultaneous validation in Ͼ1 language), 28,29 and none, to our knowledge, was validated in the Vietnamese asthma population in the United States.…”

mentioning

confidence: 99%

“…32 These factors limit the applicability of these observations for the general multiracial populations of children in many communities in the United States. Because of these potential limitations, we evaluated the predictive value of a novel asthma questionnaire, developed by Jones et al, 28 at school sites for 3 diverse ethnic groups in Orange County, 2 in the inner …”

mentioning

confidence: 99%

See 3 more Smart Citations

Predictive Value of a Cross-Cultural Asthma Case-Detection Tool in an Elementary School Population

Galant¹

2004

PEDIATRICS

View full text Add to dashboard Cite

ABSTRACT. Objective. Bronchial asthma, which affects ϳ5 million US children, is vastly underdiagnosed and treated, particularly among minorities and those of low socioeconomic status. Because current methods of detecting those at greatest risk of asthma in a multicultural setting appear inadequate, we assessed the validity and reliability of a new asthma questionnaire across 3 dominant cultures in Orange County, California (white, Hispanic, and Vietnamese).Methods. Children in grades 1, 3, and 5 and their families, in 3 different schools representative of these major ethnic groups, were randomly selected to participate in the validation process. Two schools with low socioeconomic status and dominant Hispanic or Vietnamese minorities were designated inner-city schools, whereas the third school was a suburban school with predominately white students. Participants completed a 7-question, 11-element questionnaire in their primary language, followed by an asthma evaluation (history, physical examination, and spirometry) by an asthma specialist (who was blinded with respect to the results of the questionnaire), at their respective schools. The physician then made a determination regarding the presence and severity (according to National Institutes of Health guidelines) of asthma. Several weeks later, the entire student body was asked to complete the questionnaire at home and return it to school for analysis. Validation of each item was evaluated for sensitivity, specificity, and positive and negative predictive values, and application of univariate analyses provided an estimated probability of an asthma diagnosis by the asthma specialist. A "bestfit" algorithm was determined with all 11 elements, if possible, and an abbreviated algorithm that selected the fewest-question combination that yielded the best asthma predictability was established. Reliability was established with the percent agreement between the 2 questionnaires and the statistic.Results. Of the 401 children/families who participated in the validation analysis, 45% were Hispanic, 22% white, 19% Vietnamese, and 15% other. The overall prevalence of asthma specialist-diagnosed asthma was 28%, with 65% of cases being graded as intermittent and 35% as persistent. Sixty-two percent of the children had not been previously diagnosed with asthma. There were no significant differences among cultures in sensitivity or specificity for any of the individual questions or the complete or abbreviated algorithms. The abbreviated algorithm with 3 questions, ie, question 1 (asthma in the past 2 years), question 4 (cough, chest tightness, trouble breathing, or wheezing with exercise), and question 6 (same symptoms in the morning or day in the past 4 weeks) yielded comparable sensitivity and specificity for the complete algorithm in all groups. The abbreviated algorithm had >86% predictability in detecting children with persistent asthma and 56% predictability in detecting children with intermittent asthma. Reliability was also excellent, with percent agreement usually > 80% ...

show abstract

Section: Statistical Analysesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Predictive Value of a Cross-Cultural Asthma Case-Detection Tool in an Elementary School Population

Galant¹

2004

PEDIATRICS

View full text Add to dashboard Cite

show abstract

“…This evidence also provides a rationale for the need to identify and track asthma control. 14,15 ss Clinical Evidence Inhaled Corticosteroids: Adults (>18 Years) In an NIH/NHLBI-sponsored pilot study, 17 Szefler et al compared the relative beneficial and systemic effects of 2 different ICSs in a dose-response relationship in a 24-week, parallel, open-label, multicenter trial in patients with mild-to-moderate persistent asthma using serial dosing (low to moderate to high) of ICSs. Thirty adult subjects were randomized to receive either beclomethasone dipropionate (BDP) in a metered-dose inhaler (MDI) with a spacer (OptiChamber, Respironics), or fluticasone propionate (FP) MDI with a spacer for 24 weeks.…”

Section: Figurementioning

confidence: 99%

From Asthma Severity to Asthma Control: Identification of New Guidelines

Jones

Endicott²,

Kaufman³

2006

JMCP

View full text Add to dashboard Cite

Validation of a school‐based written questionnaire for asthma case identification in Argentina

Busi

Sly

Restuccia³

et al. 2011

Pediatric Pulmonology

View full text Add to dashboard Cite

Recognition of asthma in community-based surveys can be problematic. We sought to develop and validate questionnaires that could identify elementary school-aged children likely to have asthma or who had poorly-controlled asthma. Questionnaires for parents (PQ) and students (SQ) to complete were developed using guidance on question wording from a focus group consisting of children with asthma and their parents. The gold standard for this study was a pulmonologist determination of asthma and this was used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each question and for combinations of questions. Questionnaires were distributed to 830 children attending elementary schools in Trelew, Argentina and 96% were returned. Test-retest reliability was determined in 221 randomly selected parents and children and very good levels of agreement were seen for individual questions. Asthma was diagnosed in 92 students. Overall, the PQ was able to detect asthma better than the SQ. Optimal diagnostic ability came by combining questions from the PQ and SQ. Not surprisingly, these questionnaires had a better NPV than PPV and can be used to determine which children require further evaluation.

show abstract

A School-Based Case Identification Process for Identifying Inner City Children With Asthma

Cited by 56 publications

References 17 publications

Predictive Value of a Cross-Cultural Asthma Case-Detection Tool in an Elementary School Population

Predictive Value of a Cross-Cultural Asthma Case-Detection Tool in an Elementary School Population

From Asthma Severity to Asthma Control: Identification of New Guidelines

Validation of a school‐based written questionnaire for asthma case identification in Argentina

Contact Info

Product

Resources

About