Asthma phenotypes identified by latent class analysis in the ISAAC phase II Spain study
Open accessAbstract
BACKGROUND: Classification of respiratory symptoms may help to identify different underlying asthma phenotypes reflecting differences in aetiology and prognosis of wheezing disease among children. OBJECTIVE: To determine childhood asthma phenotypes based on respiratory symptoms from a widely used questionnaire to further classify phenotypes in international settings. METHODS: Between 2000 and 2002 cross-sectional studies were performed in four centres in Spain. Parental questionnaires were used to collect information on allergic diseases in more than 4000 children aged 8-12 years. In addition, objective markers for allergic sensitization and bronchial hyperresponsiveness (BHR) were measured. Latent class analyses (LCA) were applied to identify subgroups of children according to respiratory symptoms, and then the association of these groups with relevant clinical features such as concomitant allergic disease symptoms, atopy and BHR was studied. RESULTS: We found seven classes, one corresponding to healthy children, three classes related to wheeze and three other classes mainly related to congestion and coughed-up phlegm. These tentative phenotypes differed in severity of symptoms and also in clinical correlates such as BHR and allergic sensitization. Atopy was more predominant in the 'wheeze phenotypes' whereas concomitant 'allergic' symptoms were most frequent in two of the 'wheeze phenotypes' and one of the 'cough phenotypes'. CONCLUSIONS: LCA on reported symptoms in a cross-sectional survey allowed different subgroups with meaningful clinical correlates to be defined. It remains to be investigated to what extent these groups also have different aetiologies, prognoses and therapeutic needs.
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Latent class analysis methods are able to identify novel and statistically distinct classes among individuals in a relatively unbiased way, based on measured variables that relate to asthma symptoms and/or biomarkers such as bronchial hyperresponsiveness and atopy.
“Essentially, LCA methods are able to identify novel and statistically distinct classes among individuals in a relatively unbiased way, and are based on measured variables that relate to asthma symptoms (26) and/or biomarkers such as bronchial hyperresponsiveness and atopy (27, 28).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [27]
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- Authors
- Weinmayr, G., Keller, F., Kleiner, A., du Prel, J. B., Garcia‐Marcos, L., Batllés‐Garrido, J., Garcia‐Hernandez, G., Suarez‐Varela, M. M., Strachan, D. P., & Nagel, G.
- Affiliations
- Universität Ulm (DE)
- Institute of Epidemiology and Medical Biometry Ulm University Ulm Germany
- Pediatric Respiratory and Allergy Units “Arrixaca” University Children's Hospital University of Murcia CIBER of Epidemiology and Public Health (CIBERSP) Murcia Spain
- Pediatrics Department Torrecardenas Hospital Almeria Spain
- Hospital Universitario 12 De Octubre (ES)
- Unit of Public Health and Environmental Care Department of Preventive Medicine University of Valencia Research group CIBER CB06/02/0045 CIBER actions‐Epidemiology and Public Health Research Foundation University Hospital Dr. Peset Valencia Spain
- University of London (GB)
- Corresponding author
- Weinmayr, G.
- Venue
- Clinical & Experimental Allergy
- Publisher
- Wiley
- Published
- 2013-01-18
- Volume
- 43
- Issue
- 2
- Pages
- 223-232
- ISSN
- 0954-7894 (ISSN-L)
- 1365-2222
- OpenAlex
- W2127160858
- Cited by
- 43
- References
- 38
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 4 · 2019: 1 · 2018: 5 · 2017: 1 · 2016: 5 · 2015: 5 · 2014: 6 · 2013: 3
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Clinical & Experimental Allergy (publishedVersion)
- PubMed (publishedVersion)
- Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion, cc-by-nc-nd)
- Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Keywords
- childhood asthma, asthma phenotypes, wheezing, respiratory symptoms, latent class analysis, airway hyperresponsiveness, allergen sensitization, atopy, cough, sputum, allergic diseases
- MeSH terms
- Asthma, Child, Cross-Sectional Studies, Female, Humans, Male, Phenotype, Surveys and Questionnaires, Respiratory Sounds, Risk Factors, Spain, Anti-Asthmatic Agents
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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