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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Kelly A Quinn, MPH, Research Institute, Evanston Northwestern Healthcare, 2650 Ridge Avenue, Evanston, IL 60201, 847-570-1740, kquinn@enh.org, Raoul L Wolf, MD, Dept. of Asthma, Allergy and Immunology, La Rabida Children's Hospital and Research Center, East 65th Street at Lake Michigan, Chicago, IL 60649, and Carolyn A Berry, PhD, Wagner Graduate School of Public Service, New York University, 726 Broadway, 5th Floor, New York, NY 10003.
Purpose. Asthma is the leading cause of school absences and the chronic illness accounting for the most childhood hospitalizations. Allergies are very common among children and are a major trigger of asthma attacks. Underdiagnosis of these conditions is a problem. It is not feasible for schools and other non-medical settings to arrange for physician diagnosis of all children, and many questionnaires are too complicated to administer without assistance. We developed a brief, parent-completed screen for asthma and allergies that can be readily used in schools and similar settings. We then validated the screen against the "gold standard," a medical assessment by a pediatric asthma and allergy specialist. Methods. We distributed the screen in 3 low-income, inner-city elementary schools to 1725 children and got an overall response rate of 72 % (1237 completed screens). We randomly selected students for medical assessment including history and physical exam. The physician was blinded to screen responses and assigned each of the 129 participating children an asthma and an allergy score of no or possible/definite. Results. Analyses demonstrated that the optimal screen includes 4 asthma items and 4 allergy items designed to be scored separately. The screen has 73% sensitivity and 74% specificity for asthma and 76% sensitivity and 79% specificity for allergies. The screen identified 20% of students as diagnosed asthmatics and 18% as possible, undiagnosed asthmatics and 24% of students as having allergic rhinitis. The screen has good validity, is brief, easily scored, inexpensive and has potential for use in school systems.
Learning Objectives:
Keywords: Screening Instruments, Asthma
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.