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Publication Detail

Title: Validating childhood symptoms with physician-diagnosed allergic rhinitis.

Authors: Kim, Haejin; Levin, Linda; LeMasters, Grace K; Villareal, Manuel; Evans, Sherry; Lockey, James E; Khurana Hershey, Gurjit K; Bernstein, David I

Published In Ann Allergy Asthma Immunol, (2012 Apr)

Abstract: BACKGROUND: Multiple population-based and high-risk cohort studies use parental questionnaire responses to define allergic rhinitis (AR) in children. Individual questionnaire items have not been validated by comparison with physician-diagnosed AR (PDAR). OBJECTIVE: To identify routine clinical questions that best agree with a physician diagnosis of AR and can be used for early case identification. METHODS: Children participating in a longitudinal birth cohort study were evaluated at ages 1 through 4 and at age 7 (n = 531) using questionnaires, physical examinations, and skin prick tests (SPT) with 15 aeroallergens (AG). Parents answered 3 stem questions pertaining to their child, including presence of nasal symptoms absent a cold/flu (ISAAC-validated question), presence of hayfever, and ocular itch. Substem questions were answered with details regarding seasonality, nasal triggers, and ocular seasonality. A global assessment of allergic diseases, including AR, was performed by a specialty-trained clinician. Percent agreement, sensitivity, specificity, and positive predictive values were assessed for individual stem and substem questions. RESULTS: Positive response to having hayfever and presence of ocular symptoms had the highest specificity (84% and 69%, respectively) and the highest percent agreement (74% and 68%) with PDAR. Identification of triggers for nasal and ocular symptoms had the highest sensitivity (89%). Positive predictive values ranged from 31 to 39%. Combining 2 responses with highest agreement increased specificity for PDAR to 91%. CONCLUSION: Responses to hayfever and ocular symptoms had better specificity and percent agreement with PDAR than the ISAAC-validated questionnaire item. Combining 2 rhinitis questions sharply increases specificity and may improve diagnostic accuracy of clinical questions.

PubMed ID: 22469440 Exiting the NIEHS site

MeSH Terms: No MeSH terms associated with this publication

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