Balemans Walter A F, van der Ent Cornelis K, Schilder Anne G M, Sanders Elisabeth A M, Zielhuis Gerhard A, Rovers Maroeska M
Department of Paediatric Respiratory Medicine, Wilhelmina Children's Hospital, University Medical Centre Utrecht, KH 01.419.0, PO Box 85090, Lundlaan 6, 3508 AB Utrecht, The Netherlands.
J Clin Epidemiol. 2006 Nov;59(11):1207-12. doi: 10.1016/j.jclinepi.2006.02.011. Epub 2006 Aug 24.
To develop an easily applicable prediction rule for asthma in young adulthood using childhood characteristics.
A total of 1,055 out of 1,328 members of a Dutch birth cohort were followed from 2 to 21 years of age. Univariate and multivariate logistic regression analyses were used to evaluate the predictive value of childhood characteristics on asthma at 21 years of age. A prognostic function was developed, and the area under the receiving operating characteristic (ROC) curve was used to estimate the predictive ability of the prognostic models.
Of the 693 responding subjects, 86 (12%) were diagnosed with asthma. Independent prognostic factors at ages 2 and 4 years were female gender (odds ratios (OR) 1.9 and 2.1; 95% confidence intervals (CI) 1.2-3.2 and 1.3-2.5), smoking mother (OR 1.6 and 1.6; CI 1.0-2.7 and 1.0-2.6), lower respiratory tract illness (OR 1.9 and 2.4; CI 1.0-3.6 and 1.4-4.0), and atopic parents (OR 2.1 and 1.9; CI 1.3-3.4 and 1.2-3.1). The predictive power of both models was poor; area under ROC curve was 0.66 and 0.68, respectively.
Asthma in young adulthood could not be predicted satisfactorily based on childhood characteristics. Nevertheless, we propose that this method is further tested as a tool to predict development of asthma.
利用儿童期特征制定一种易于应用的青年期哮喘预测规则。
对荷兰一个出生队列的1328名成员中的1055名从2岁至21岁进行随访。采用单因素和多因素逻辑回归分析评估儿童期特征对21岁时哮喘的预测价值。建立了一个预后函数，并使用受试者工作特征（ROC）曲线下面积来估计预后模型的预测能力。
在693名有回应的受试者中，86名（12%）被诊断为哮喘。2岁和4岁时的独立预后因素为女性（优势比（OR）分别为1.9和2.1；95%置信区间（CI）为1.2 - 3.2和1.3 - 2.5）、母亲吸烟（OR分别为1.6和1.6；CI为1.0 - 2.7和1.0 - 2.6）、下呼吸道疾病（OR分别为1.9和2.4；CI为1.0 - 3.6和1.4 - 4.0）以及有特应性的父母（OR分别为2.1和1.9；CI为1.3 - 3.4和1.2 - 3.1）。两个模型的预测能力都较差；ROC曲线下面积分别为0.66和0.68。
基于儿童期特征不能令人满意地预测青年期哮喘。然而，我们建议将该方法作为预测哮喘发展的工具进一步进行测试。
