Asthma and lower airway diseaseValidation of the Asthma Predictive Index and comparison with simpler clinical prediction rules
Section snippets
Development cohort
The TCRS, a birth cohort study in Arizona, contacted 1596 healthy infants between 1980 and 1984.23 Baseline clinical information for the API was assessed from questionnaires at enrollment and at ages 2 and 3 years and from a blood sample at age 1 year; the outcome asthma was assessed at ages 6, 8, 11, and 13 years (Table I).1, 24
Validation cohort
The Leicester 1998b Respiratory Cohort (LRC, www.leicestercohorts.org) is a population-based stratified random sample of children recruited in 1998 at the age of 1 year
Study populations
The TCRS and LRC are large, unselected, mixed-ethnicity prospective cohorts with comparable sex balances and ages at follow-ups (Table I). Children in LRC were recruited ∼15 years later, live in a different climate zone, and provided no blood sample.
In LRC, 3392 of 4300 invited children replied to the first postal questionnaire, and 2948 provided enough information at baseline to determine the API, of whom 1954 also provided information on asthma at 7 or 10 years. These children did not differ
Discussion
We found that the API developed in Tucson predicted asthma at school age in Leicestershire similarly, despite disparities in location, recruitment period, and predictor variables. This supports the generalizability of the API to other settings. Its predictive accuracy, however, was modest, and simpler rules based only on frequency of preschool wheeze showed comparable performance, suggesting that the additional criteria included in the API—1 of them requiring a blood sample—do not improve
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Cited by (0)
Supported by the Swiss National Science Foundation (PDFMP3-123162, 823B-046481, 3200B0-122341) and Asthma UK (07/048).
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.