The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Defining asthma in epidemiological studies
Open accessAbstract
It has been suggested that, in epidemiological studies, asthma should be defined as symptomatic bronchial hyperresponsiveness (BHR). This paper critically examines the validity of this and alternative methods of defining asthma by reviewing population-based studies validating BHR and symptom questionnaires against asthma defined on the basis of a clinical assessment. It is emphasized that a single definition of asthma will not be applicable to all studies. When the aim of a study is to compare differences in prevalence of asthma between populations, Youden's Index (sensitivity + specificity - 1) is the best single measure of validity. BHR has similar or better specificity, but much worse sensitivity, and therefore a worse Youden's Index, than symptom questionnaires. When the aim is to estimate relative risks, the validity of the definition of asthma depends more on its positive predictive value. Therefore, more specific methods of detecting asthmatics, such as severe symptoms, diagnoses of asthma, or symptomatic BHR may be most useful in cohort and case-control studies. In contrast, conversely, the method of choice for the first phase of prevalence comparisons is standardized written or video symptom questionnaires. In order to explore reasons for the differences in asthma prevalence, and to estimate possible differential symptom reporting, questionnaires can be supplemented with bronchial hyperresponsiveness and other testing in subsamples of the symptomatic and nonsymptomatic subjects. However, symptoms and bronchial hyperresponsiveness should usually be analysed separately rather than combined due to the poor agreement between bronchial hyperresponsiveness and clinical asthma.
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Cites
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Cited by
Benchimol, E. I., Manuel, D. G., To, T., Griffiths, A. M., Rabeneck, L., & Guttmann, A. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.10.006 · Cited by 368
Dog exposure in infancy decreases the subsequent risk of frequent wheeze but not of atopy
Remes, S. T., Castro-Rodriguez, J. A., Holberg, C. J., Martinez, F. D., & Wright, A. L. (2001) · Journal of Allergy and Clinical Immunology · doi:10.1067/mai.2001.117797 · Cited by 282
Increased risk of childhood asthma from antibiotic use in early life
Kozyrskyj, A. L., Ernst, P., & Becker, A. B. (2007) · Chest · doi:10.1378/chest.06-3008 · Cited by 272
Lee, S., Wong, W., & Lau, Y. (2004) · Pediatric Allergy and Immunology · doi:10.1046/j.0905-6157.2003.00109.x · Cited by 140
Excess incidence of asthma among Finnish cleaners employed in different industries
Karjalainen, A., Martikainen, R., Karjalainen, J., Klaukka, T., & Kurppa, K. (2002) · European Respiratory Journal · doi:10.1183/09031936.02.00201002 · Cited by 81
Metadata
- Authors
- Pekkanen, J., & Pearce, N.
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 1999-10
- Volume
- 14
- Issue
- 4
- Pages
- 951
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W1964193801
- Cited by
- 279
- References
- 32
- FWCI
- 5.71
- Type
- journal article
- Language
- en
- Open access
- bronze
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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