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Epidemiologic methods of assessing asthma and wheezing episodes in longitudinal studies: measures of change and stability

Epidemiologic methods of assessing asthma and wheezing episodes in longitudinal studies: measures of change and stability
Epidemiologic methods of assessing asthma and wheezing episodes in longitudinal studies: measures of change and stability

Background: In settings in which diseases wax and wane, there is a need to measure disease dynamics in longitudinal studies. Traditional measures of disease occurrence (eg, cumulative incidence) do not address change or stability or are limited to stable cohorts (eg, incidence) and may thus lead to erroneous conclusions. To illustrate how different measures can be used to detect disease dynamics, we investigated sex differences in the occurrence of asthma and wheezing, using a population-based study cohort that covered the first 18 years of life.

Methods: In the Isle of Wight birth cohort (n = 1456), prevalence, incidence, cumulative incidence, positive and negative transitions, and remission were determined at ages 1 or 2, 4, 10, and 18 years. Latent transition analysis was used to simultaneously identify classes of asthma and wheezing (related phenotypes) and characterize transition probabilities over time. Trajectory analysis was used to characterize the natural history of asthma and wheezing.

Results: Regarding time-specific changes, positive and negative transition probabilities were more informative than other measures of associations because they revealed a sex switchover in asthma prevalence (P < 0.05). Transition probabilities were able to identify the origin of a sex-specific dynamic; in particular, prior wheezing transitioned to asthma at age 18 years among girls but not among boys. In comparison with latent transition analysis, trajectory analysis did not directly identify a switchover in prevalence among boys and girls.

Conclusions: In longitudinal analyses, transition analyses that impose minimal restrictions on data are needed in order to produce appropriate information on disease dynamics.

Adolescent, Asthma/diagnosis, Child, Child, Preschool, Epidemiologic Methods, Female, Humans, Incidence, Infant, Longitudinal Studies, Male, Prevalence, Respiratory Sounds/diagnosis, Sex Distribution, United Kingdom/epidemiology
0917-5040
399-410
Soto-Ramírez, Nelís
3526295b-e2ec-4cf3-bc74-088d10943f45
Ziyab, Ali H.
12905e44-3fd1-47c2-98e5-35320e89815b
Karmaus, Wilfried
281d0e53-6b5d-4d38-9732-3981b07cd853
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Ewart, Susan
28667421-3cf7-43d7-b1c3-ca27564938f7
Arshad, Syed Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Soto-Ramírez, Nelís
3526295b-e2ec-4cf3-bc74-088d10943f45
Ziyab, Ali H.
12905e44-3fd1-47c2-98e5-35320e89815b
Karmaus, Wilfried
281d0e53-6b5d-4d38-9732-3981b07cd853
Zhang, Hongmei
9f774048-54d6-4321-a252-3887b2c76db0
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Ewart, Susan
28667421-3cf7-43d7-b1c3-ca27564938f7
Arshad, Syed Hasan
917e246d-2e60-472f-8d30-94b01ef28958

Soto-Ramírez, Nelís, Ziyab, Ali H., Karmaus, Wilfried, Zhang, Hongmei, Kurukulaaratchy, Ramesh J., Ewart, Susan and Arshad, Syed Hasan (2013) Epidemiologic methods of assessing asthma and wheezing episodes in longitudinal studies: measures of change and stability. Journal of Epidemiology, 23 (6), 399-410. (doi:10.2188/jea.je20120201).

Record type: Article

Abstract

Background: In settings in which diseases wax and wane, there is a need to measure disease dynamics in longitudinal studies. Traditional measures of disease occurrence (eg, cumulative incidence) do not address change or stability or are limited to stable cohorts (eg, incidence) and may thus lead to erroneous conclusions. To illustrate how different measures can be used to detect disease dynamics, we investigated sex differences in the occurrence of asthma and wheezing, using a population-based study cohort that covered the first 18 years of life.

Methods: In the Isle of Wight birth cohort (n = 1456), prevalence, incidence, cumulative incidence, positive and negative transitions, and remission were determined at ages 1 or 2, 4, 10, and 18 years. Latent transition analysis was used to simultaneously identify classes of asthma and wheezing (related phenotypes) and characterize transition probabilities over time. Trajectory analysis was used to characterize the natural history of asthma and wheezing.

Results: Regarding time-specific changes, positive and negative transition probabilities were more informative than other measures of associations because they revealed a sex switchover in asthma prevalence (P < 0.05). Transition probabilities were able to identify the origin of a sex-specific dynamic; in particular, prior wheezing transitioned to asthma at age 18 years among girls but not among boys. In comparison with latent transition analysis, trajectory analysis did not directly identify a switchover in prevalence among boys and girls.

Conclusions: In longitudinal analyses, transition analyses that impose minimal restrictions on data are needed in order to produce appropriate information on disease dynamics.

Full text not available from this repository.

More information

e-pub ahead of print date: 31 August 2013
Keywords: Adolescent, Asthma/diagnosis, Child, Child, Preschool, Epidemiologic Methods, Female, Humans, Incidence, Infant, Longitudinal Studies, Male, Prevalence, Respiratory Sounds/diagnosis, Sex Distribution, United Kingdom/epidemiology

Identifiers

Local EPrints ID: 446562
URI: http://eprints.soton.ac.uk/id/eprint/446562
ISSN: 0917-5040
PURE UUID: 41524757-12a2-4ef7-b1c6-fc4eed122af4
ORCID for Ramesh J. Kurukulaaratchy: ORCID iD orcid.org/0000-0002-1588-2400

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Date deposited: 15 Feb 2021 17:31
Last modified: 17 Mar 2021 02:36

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Contributors

Author: Nelís Soto-Ramírez
Author: Ali H. Ziyab
Author: Wilfried Karmaus
Author: Hongmei Zhang
Author: Susan Ewart

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