Validation of screening tool for diagnosis of childhood asthma by exclusion method

S. Kondekar, Nimisha S. Dange, S. Rathi
{"title":"Validation of screening tool for diagnosis of childhood asthma by exclusion method","authors":"S. Kondekar, Nimisha S. Dange, S. Rathi","doi":"10.32677/ijch.v9i6.3263","DOIUrl":null,"url":null,"abstract":"Introduction: In the 21st century, with growing concerns over over-diagnosis of asthma in children; the diagnosis of asthma is left as diagnosis by exclusion. On the same lines, an attempt had been made to device a criteria to exclude diagnosis of asthma. The criteria are labeled as other than asthma (OTA) criteria. It is assumed that if a case does not satisfy OTA tool, then it is likely to be asthma. This study had objectives of validation of screening tool by expert and validation of OTA tool by direct application on patients. Materials and Methods: This was an observational and prospective study only. Total 120 cases were enrolled. Questionnaire applied on all cases and all of the 120 cases were followed up on day 30 with clinical diagnosis and were included in results estimation. Results: According to the screening tool, out of 120 cases, 83 cases (69.2%) were found to have OTA while 37 cases (30.8%) werefound to have non-OTA. However, among this study population, 94 cases (78.3%) had non-asthma and 26 cases (21.7%) had clinical diagnosis of asthma taken as gold standard. The association between clinical diagnosis and total score based diagnosis was found to bestatistically significant (p=1.96E-07). Sensitivity was 91.57% and specificity was 51.35% which helps detect OTA cases effectively. Predictive value of positive test is 80.85% and predictive value of negative test was 73.08%. OTA category has relative risk of 3.003 for diagnosis of non-asthma as compared to 0.262 for non-OTA category being almost 3 times in comparison to non-OTA category. Thus, OTA was consistent with non-asthma diagnosis. Conclusion: On direct application of patients in prospective study, this tool has proven its value as an effective screening tool. This was the first such study to diagnose asthma by exclusion, devising a criterion for other than asthma conditions.","PeriodicalId":22476,"journal":{"name":"The Indian journal of child health","volume":"31 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Indian journal of child health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.32677/ijch.v9i6.3263","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: In the 21st century, with growing concerns over over-diagnosis of asthma in children; the diagnosis of asthma is left as diagnosis by exclusion. On the same lines, an attempt had been made to device a criteria to exclude diagnosis of asthma. The criteria are labeled as other than asthma (OTA) criteria. It is assumed that if a case does not satisfy OTA tool, then it is likely to be asthma. This study had objectives of validation of screening tool by expert and validation of OTA tool by direct application on patients. Materials and Methods: This was an observational and prospective study only. Total 120 cases were enrolled. Questionnaire applied on all cases and all of the 120 cases were followed up on day 30 with clinical diagnosis and were included in results estimation. Results: According to the screening tool, out of 120 cases, 83 cases (69.2%) were found to have OTA while 37 cases (30.8%) werefound to have non-OTA. However, among this study population, 94 cases (78.3%) had non-asthma and 26 cases (21.7%) had clinical diagnosis of asthma taken as gold standard. The association between clinical diagnosis and total score based diagnosis was found to bestatistically significant (p=1.96E-07). Sensitivity was 91.57% and specificity was 51.35% which helps detect OTA cases effectively. Predictive value of positive test is 80.85% and predictive value of negative test was 73.08%. OTA category has relative risk of 3.003 for diagnosis of non-asthma as compared to 0.262 for non-OTA category being almost 3 times in comparison to non-OTA category. Thus, OTA was consistent with non-asthma diagnosis. Conclusion: On direct application of patients in prospective study, this tool has proven its value as an effective screening tool. This was the first such study to diagnose asthma by exclusion, devising a criterion for other than asthma conditions.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
排除法诊断儿童哮喘筛查工具的验证
在21世纪,随着人们对儿童哮喘过度诊断的日益关注;对哮喘的诊断保留为排除诊断。同样,人们也曾试图制定一种排除哮喘诊断的标准。这些标准被标记为哮喘(OTA)标准以外的标准。假设一个病例不符合OTA工具,那么它很可能是哮喘。本研究的目的是通过专家对筛查工具进行验证,并通过直接应用于患者对OTA工具进行验证。材料和方法:这只是一项观察性和前瞻性研究。共入组120例。所有病例均采用问卷调查,所有120例病例均于临床诊断后第30天进行随访,纳入结果评估。结果:根据筛查工具,120例患者中发现有OTA 83例(69.2%),非OTA 37例(30.8%)。然而,在本研究人群中,94例(78.3%)患者无哮喘,26例(21.7%)患者以临床诊断哮喘为金标准。临床诊断与基于总分的诊断之间存在统计学意义(p=1.96E-07)。灵敏度为91.57%,特异度为51.35%,可有效发现OTA病例。阳性预测值为80.85%,阴性预测值为73.08%。OTA类别诊断非哮喘的相对风险为3.003,而非OTA类别诊断非哮喘的相对风险为0.262,几乎是非OTA类别的3倍。因此,OTA与非哮喘诊断一致。结论:在前瞻性研究中直接应用于患者,证明了该工具作为一种有效的筛查工具的价值。这是第一个通过排除来诊断哮喘的研究,为哮喘以外的疾病设计一个标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Clinical and etiopathological profile of pancytopenia in children (1-18 years): A study from tertiary care center of Bundelkhand region, central India Urinary tract infection in pediatric patients – Recent updates Pediatric autism spectrum disorder: Role of yoga prana vidya system as complementary medicine in accelerating patient progress An observational study to evaluate weight gain of exclusively breastfed infants who feed only while sleeping Fibular hemimelia in a neonate
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1