PMID- 19368704
OWN - NLM
STAT- MEDLINE
DCOM- 20090611
LR  - 20211020
IS  - 1471-2466 (Electronic)
IS  - 1471-2466 (Linking)
VI  - 9
DP  - 2009 Apr 15
TI  - Prediction and treatment of asthma in preschool children at risk: study design 
      and baseline data of a prospective cohort study in general practice (ARCADE).
PG  - 13
LID - 10.1186/1471-2466-9-13 [doi]
AB  - BACKGROUND: Asthma is a difficult diagnosis to establish in preschool children. A 
      few years ago, our group presented a prediction rule for young children at risk 
      for asthma in general practice. Before this prediction rule can safely be used in 
      practice, cross-validation is required. In addition, general practitioners face 
      many therapeutic management decisions in children at risk for asthma. The 
      objectives of the study are: (1) identification of predictors for asthma in 
      preschool children at risk for asthma with the aim of cross-validating an earlier 
      derived prediction rule; (2) compare the effects of different treatment 
      strategies in preschool children. DESIGN: In this prospective cohort study one to 
      five year old children at risk of developing asthma were selected from general 
      practices. At risk was defined as 'visited the general practitioner with 
      recurrent coughing (>or= 2 visits), wheezing (>or=1) or shortness of breath 
      (>or=1) in the previous 12 months'. All children in this prospective cohort study 
      will be followed until the age of six. For our prediction rule, demographic data, 
      data with respect to clinical history and additional tests (specific 
      immunoglobulin E (IgE), fractional exhaled nitric oxide (FENO), peak expiratory 
      flow (PEF)) are collected. History of airway specific medication use, symptom 
      severity and health-related quality of life (QoL) are collected to estimate the 
      effect of different treatment intensities (as expressed in GINA levels) using 
      recently developed statistical techniques. In total, 1,938 children at risk of 
      asthma were selected from general practice and 771 children (40%) were enrolled. 
      At the time of writing, follow-up for all 5-year olds and the majority of the 
      4-year olds is complete. The total and specific IgE measurements at baseline were 
      carried out by 87% of the children. Response rates to the repeated questionnaires 
      varied from 93% at baseline to 73% after 18 months follow-up; 89% and 87% 
      performed PEF and FENO measurements, respectively. DISCUSSION: In this study a 
      prediction rule for asthma in young children, to be used in (general) practice, 
      will be cross-validated. Our study will also provide more insight in the effect 
      of treatment of asthma in preschool children.
FAU - van Wonderen, Karina E
AU  - van Wonderen KE
AD  - Department of General Practice, Academic Medical Center, Amsterdam, the 
      Netherlands. k.vanwonderen@amc.uva.nl
FAU - van der Mark, Lonneke B
AU  - van der Mark LB
FAU - Mohrs, Jacob
AU  - Mohrs J
FAU - Geskus, Ronald B
AU  - Geskus RB
FAU - van der Wal, Willem M
AU  - van der Wal WM
FAU - van Aalderen, Wim M C
AU  - van Aalderen WM
FAU - Bindels, Patrick J E
AU  - Bindels PJ
FAU - ter Riet, Gerben
AU  - ter Riet G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20090415
PL  - England
TA  - BMC Pulm Med
JT  - BMC pulmonary medicine
JID - 100968563
RN  - 0 (Anti-Asthmatic Agents)
SB  - IM
MH  - Anti-Asthmatic Agents/*therapeutic use
MH  - Asthma/*diagnosis/*drug therapy/epidemiology
MH  - Child, Preschool
MH  - Family Practice/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Netherlands/epidemiology
MH  - Peak Expiratory Flow Rate/physiology
MH  - Prevalence
MH  - Prognosis
MH  - Prospective Studies
MH  - Quality of Life
MH  - Risk Factors
MH  - Spirometry
PMC - PMC2678979
EDAT- 2009/04/17 09:00
MHDA- 2009/06/12 09:00
PMCR- 2009/04/15
CRDT- 2009/04/17 09:00
PHST- 2008/12/08 00:00 [received]
PHST- 2009/04/15 00:00 [accepted]
PHST- 2009/04/17 09:00 [entrez]
PHST- 2009/04/17 09:00 [pubmed]
PHST- 2009/06/12 09:00 [medline]
PHST- 2009/04/15 00:00 [pmc-release]
AID - 1471-2466-9-13 [pii]
AID - 10.1186/1471-2466-9-13 [doi]
PST - epublish
SO  - BMC Pulm Med. 2009 Apr 15;9:13. doi: 10.1186/1471-2466-9-13.