Lisik Daniil, Özuygur Ermis Saliha Selin, Milani Gregorio Paolo, Spolidoro Giulia Carla Immacolata, Ercan Selin, Salisu Michael, Odetola Faozyat, Ghiglioni Daniele Giovanni, Pylov Danylo, Goksör Emma, Basna Rani, Wennergren Göran, Kankaanranta Hannu, Nwaru Bright I
Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Eur Respir Rev. 2025 Jan 8;34(175). doi: 10.1183/16000617.0160-2024. Print 2025 Jan.
Numerous studies have characterised trajectories of asthma and allergy in children using machine learning, but with different techniques and mixed findings. The present work aimed to summarise the evidence and critically appraise the methodology.
10 databases were searched. Screening, data extraction and quality assessment were performed in pairs. Trajectory characteristics were tabulated and visualised. Associated risk factor and outcome estimates were pooled using a random-effects meta-analysis.
89 studies were included. Early-onset (infancy) persistent, mid-onset (∼2-5 years) persistent, early-onset early-resolving (within ∼2 years) and early-onset mid-resolving (by ∼3-6 years) wheezing and eczema, respectively, were the most commonly identified disease trajectories. Intermediate/transient trajectories were rare. Male sex was associated with a higher risk of most wheezing trajectories and possibly with early-resolving eczema, while being slightly protective against mid-onset persistent eczema. Parental disease/genetic markers were associated with persistent trajectories of wheezing and eczema, respectively. Prenatal (and less so postnatal) tobacco smoke exposure was associated with most wheezing trajectories, as were lower respiratory tract infections in infancy (particularly with the early-onset resolving patterns). Most studies (69%) were of low methodological quality (particularly in modelling approaches and reporting). Few studies investigated allergic multimorbidity, allergic rhinitis and food allergy.
Childhood asthma/wheezing and eczema can be characterised by a few relatively consistent trajectories, with some actionable risk factors such as pre-/postnatal smoke exposure. Improved computational methodology is warranted to better assess generalisability and elucidate the validity of intermediate/transient trajectories. Likewise, allergic multimorbidity and trajectories of allergic rhinitis and food allergy need to be further elucidated.
众多研究利用机器学习对儿童哮喘和过敏的病程进行了特征描述，但采用的技术不同，结果也参差不齐。本研究旨在总结相关证据并严格评估其方法。
检索了10个数据库。由两人一组进行筛选、数据提取和质量评估。将病程特征制成表格并可视化。使用随机效应荟萃分析汇总相关风险因素和结局估计值。
纳入89项研究。最常确定的疾病病程分别为早发型（婴儿期）持续性、中发型（约2 - 5岁）持续性、早发型早期缓解型（约2年内）和早发型中期缓解型（约3 - 6岁）喘息和湿疹。中间/短暂病程罕见。男性患大多数喘息病程的风险较高，可能与早期缓解型湿疹有关，而对中发型持续性湿疹有轻微保护作用。父母疾病/基因标记分别与喘息和湿疹的持续性病程有关。产前（产后影响较小）接触烟草烟雾与大多数喘息病程有关，婴儿期下呼吸道感染（尤其是早发型缓解型）也与之有关。大多数研究（69%）方法学质量较低（尤其是在建模方法和报告方面）。很少有研究调查过敏性多重疾病、过敏性鼻炎和食物过敏。
儿童哮喘/喘息和湿疹可通过一些相对一致的病程来表征，存在一些可采取行动的风险因素，如产前/产后接触烟雾。需要改进计算方法，以更好地评估可推广性并阐明中间/短暂病程的有效性。同样，过敏性多重疾病以及过敏性鼻炎和食物过敏的病程也需要进一步阐明。
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