Validation of a multistage asthma case-detection procedure for elementary school children

Lynn B Gerald, Roni Grad, Anne Turner-Henson, Coralie Hains, Shenghui Tang, Ronald Feinstein, Keith Wille, Sue Erwin, William C. Bailey

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective. The purpose of this study was to validate a 3-stage asthma case-detection procedure for elementary school-aged children. Methods. The study was performed in 10 elementary schools in 4 inner-city school systems, with a total enrollment of 3539 children. Results of the case-detection procedure were compared with the diagnosis of an asthma specialist study physician, to determine the sensitivity and specificity of the case-detection procedure. Results. Ninety-eight percent of children returned the asthma symptoms questionnaires, and 79% of those children consented to additional testing. Results indicated that the 3-stage procedure had good validity, with sensitivity, specificity, and predictive value of 82%, 93%, and 93%, respectively. A 2-stage procedure using questionnaires and spirometry had similar validity, with sensitivity, specificity, and predictive value of 78%, 93%, and 93%, respectively. However, given the time and expense associated with the 2- or 3-stage procedure and the difficulty of obtaining physician follow-up evaluation of the case-detection diagnosis, schools may prefer to use a 2-item questionnaire that has a lower sensitivity (66%) but higher specificity (96%) and predictive value (95%). Conclusions. Case-detection programs are generally well received by school personnel and can identify children with unrecognized or undiagnosed disease, as well as those with a current diagnosis but poorly controlled disease. This study yields substantial information regarding the validity, yield, and specific types of children who might be identified with the use of such procedures. For the choice of the method of case detection used in a school, the strengths and weaknesses of each procedure, as well as the resources available for case detection, physician referral, and follow-up procedures, must be considered.

Original languageEnglish (US)
JournalPediatrics
Volume114
Issue number4
DOIs
StatePublished - Oct 2004
Externally publishedYes

Fingerprint

Asthma
Physicians
Sensitivity and Specificity
Spirometry
Referral and Consultation
Surveys and Questionnaires

Keywords

  • Asthma
  • Case detection
  • Children

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Validation of a multistage asthma case-detection procedure for elementary school children. / Gerald, Lynn B; Grad, Roni; Turner-Henson, Anne; Hains, Coralie; Tang, Shenghui; Feinstein, Ronald; Wille, Keith; Erwin, Sue; Bailey, William C.

In: Pediatrics, Vol. 114, No. 4, 10.2004.

Research output: Contribution to journalArticle

Gerald, LB, Grad, R, Turner-Henson, A, Hains, C, Tang, S, Feinstein, R, Wille, K, Erwin, S & Bailey, WC 2004, 'Validation of a multistage asthma case-detection procedure for elementary school children', Pediatrics, vol. 114, no. 4. https://doi.org/10.1542/peds.2004-0455
Gerald, Lynn B ; Grad, Roni ; Turner-Henson, Anne ; Hains, Coralie ; Tang, Shenghui ; Feinstein, Ronald ; Wille, Keith ; Erwin, Sue ; Bailey, William C. / Validation of a multistage asthma case-detection procedure for elementary school children. In: Pediatrics. 2004 ; Vol. 114, No. 4.
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