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Titolo:
Are peak flow and symptom measures good predictors of asthma hospitalizations and unscheduled visits?
Autore:
Mortimer, KM; Redline, S; Kattan, M; Wright, EC; Kercsmar, CM;
Indirizzi:
Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 th, Dept Epidemiol, Boston, MA 02115 USA Rainbow Babies & Childrens Hosp, Dept Pediat, Cleveland, OH 44106 USA Rainbow Babies & Childrens Hosp Cleveland OH USA 44106 land, OH 44106 USA Mt Sinai Sch Med, Dept Pediat, New York, NY USA Mt Sinai Sch Med New YorkNY USA Sch Med, Dept Pediat, New York, NY USA New England Res Inst Inc, Watertown, MA USA New England Res Inst Inc Watertown MA USA es Inst Inc, Watertown, MA USA
Titolo Testata:
PEDIATRIC PULMONOLOGY
fascicolo: 3, volume: 31, anno: 2001,
pagine: 190 - 197
SICI:
8755-6863(200103)31:3<190:APFASM>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
INNER-CITY CHILDREN; EXPIRATORY FLOW; RESPIRATORY SYMPTOMS; CHILDHOOD ASTHMA; VARIABILITY;
Keywords:
peak expiratory flow; asthma symptoms; prediction; children; epidemiology;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Mortimer, KM Univ Calif Berkeley, Sch Publ Hlth, MC 7370,1918 Univ Ave, Berkeley, CA 94720 USA Univ Calif Berkeley MC 7370,1918 Univ Ave Berkeley CA USA 94720
Citazione:
K.M. Mortimer et al., "Are peak flow and symptom measures good predictors of asthma hospitalizations and unscheduled visits?", PEDIAT PULM, 31(3), 2001, pp. 190-197

Abstract

Epidemiologic studies of pediatric respiratory health often include objective measures such as peak expiratory flow (PEF), and subjective measures such as symptom reports. These measures, however, are poorly correlated with each other, and there is little evidence that PEF is useful in predicting important health outcomes. Within a cohort of 791 inner-city children with asthma, we examined correlations between a series of five peak flow measuresand five symptom scores obtained from 2-week diaries. The strongest correlations were found between "total peak flaw lability" defined as: [(diary maximum - diary minimum)/diary mean] and "% of days withchest tightness" (r = 0.31). Logistic models evaluated peak flow and symptoms as predictors of an important health outcome: hospitalization or emergency department or unscheduled clinic visit for asthma within 30 days of starting the diary. Each of the peak flow and symptom measures was significantly related to utilization. However, the predictive power of each measure was low (range of area under ROC curve, 0.54-0.67). Models including only peak flow or symptoms had greater prediction than models with risk factors such as atopy, asthma persistence, and age. The prediction from a model with the risk factors and symptoms was not improved by adding a peak flow measureto the model (increase in area under ROC, 0.67-0.68). Stratified analyses suggest that prediction was similar in the fall vs. winter, spring, and summer months. Greater prediction of health outcomes was found among more persistent asthmatics and children who were nonatopic. These findings suggest that in a research setting, peak flow monitoring inchildren did not add prediction beyond that obtained from symptom reports.

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Documento generato il 15/07/20 alle ore 05:01:15