Prediction of adult asthma risk in early childhood using novel adult asthma predictive risk scores
Prediction of adult asthma risk in early childhood using novel adult asthma predictive risk scores
Background: numerous risk scores have been developed to predict childhood asthma. However, they may not predict asthma beyond childhood. We aim to create childhood risk scores that predict development and persistence of asthma up to young adult life.
Methods: the Isle of Wight Birth Cohort (n = 1456) was prospectively assessed up to 26 years of age. Asthma predictive scores were developed based on factors during the first 4 years, using logistic regression and tested for sensitivity, specificity and area under the curve (AUC) for prediction of asthma at (i) 18 and (ii) 26 years, and persistent asthma (PA) (iii) at 10 and 18 years, and (iv) at 10, 18 and 26 years. Models were internally and externally validated.
Results: four models were generated for prediction of each asthma outcome. ASthma PredIctive Risk scorE (ASPIRE)-1: a 2-factor model (recurrent wheeze [RW] and positive skin prick test [+SPT] at 4 years) for asthma at 18 years (sensitivity: 0.49, specificity: 0.80, AUC: 0.65). ASPIRE-2: a 3-factor model (RW, +SPT and maternal rhinitis) for asthma at 26 years (sensitivity: 0.60, specificity: 0.79, AUC: 0.73). ASPIRE-3: a 3-factor model (RW, +SPT and eczema at 4 years) for PA-18 (sensitivity: 0.63, specificity: 0.87, AUC: 0.77). ASPIRE-4: a 3-factor model (RW, +SPT at 4 years and recurrent chest infection at 2 years) for PA-26 (sensitivity: 0.68, specificity: 0.87, AUC: 0.80). ASPIRE-1 and ASPIRE-3 scores were replicated externally. Further assessments indicated that ASPIRE-1 can be used in place of ASPIRE-2-4 with same predictive accuracy.
Conclusion: ASPIRE predicts persistent asthma up to young adult life.
allergic sensitisation, asthma, prediction, risk scores, wheeze
2969-2979
Farhan, Abdal J.
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Kothalawala, Dilini M.
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Kurukulaaratchy, Ramesh J.
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Granell, Raquel
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Simpson, Angela
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Murray, Clare
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Custovic, Adnan
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Roberts, Graham
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Zhang, Hongmei
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Arshad, S. Hasan
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November 2023
Farhan, Abdal J.
883ebffa-e6cc-4649-a7e8-b151778dc3d7
Kothalawala, Dilini M.
c22b9e92-e60a-44b6-a34b-2eb37a3a1212
Kurukulaaratchy, Ramesh J.
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Granell, Raquel
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Simpson, Angela
5591f945-0ead-46a3-a866-b7bea84a2a83
Murray, Clare
aca69df6-149c-401c-842f-5b2d8042edf1
Custovic, Adnan
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Roberts, Graham
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Zhang, Hongmei
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Arshad, S. Hasan
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Farhan, Abdal J., Kothalawala, Dilini M., Kurukulaaratchy, Ramesh J., Granell, Raquel, Simpson, Angela, Murray, Clare, Custovic, Adnan, Roberts, Graham, Zhang, Hongmei and Arshad, S. Hasan
(2023)
Prediction of adult asthma risk in early childhood using novel adult asthma predictive risk scores.
Allergy: European Journal of Allergy and Clinical Immunology, 78 (11), .
(doi:10.1111/all.15876).
Abstract
Background: numerous risk scores have been developed to predict childhood asthma. However, they may not predict asthma beyond childhood. We aim to create childhood risk scores that predict development and persistence of asthma up to young adult life.
Methods: the Isle of Wight Birth Cohort (n = 1456) was prospectively assessed up to 26 years of age. Asthma predictive scores were developed based on factors during the first 4 years, using logistic regression and tested for sensitivity, specificity and area under the curve (AUC) for prediction of asthma at (i) 18 and (ii) 26 years, and persistent asthma (PA) (iii) at 10 and 18 years, and (iv) at 10, 18 and 26 years. Models were internally and externally validated.
Results: four models were generated for prediction of each asthma outcome. ASthma PredIctive Risk scorE (ASPIRE)-1: a 2-factor model (recurrent wheeze [RW] and positive skin prick test [+SPT] at 4 years) for asthma at 18 years (sensitivity: 0.49, specificity: 0.80, AUC: 0.65). ASPIRE-2: a 3-factor model (RW, +SPT and maternal rhinitis) for asthma at 26 years (sensitivity: 0.60, specificity: 0.79, AUC: 0.73). ASPIRE-3: a 3-factor model (RW, +SPT and eczema at 4 years) for PA-18 (sensitivity: 0.63, specificity: 0.87, AUC: 0.77). ASPIRE-4: a 3-factor model (RW, +SPT at 4 years and recurrent chest infection at 2 years) for PA-26 (sensitivity: 0.68, specificity: 0.87, AUC: 0.80). ASPIRE-1 and ASPIRE-3 scores were replicated externally. Further assessments indicated that ASPIRE-1 can be used in place of ASPIRE-2-4 with same predictive accuracy.
Conclusion: ASPIRE predicts persistent asthma up to young adult life.
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Allergy - 2023 - Farhan
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Accepted/In Press date: 2 August 2023
e-pub ahead of print date: 3 September 2023
Published date: November 2023
Additional Information:
Funding Information:
Isle of Wight Cohort: The Isle of Wight Birth Cohort assessments have been supported by the National Institutes of Health USA (Grant no. R01 HL082925, R01 AI121226), Asthma UK (Grant no. 364) and the David Hide Asthma and Allergy Research Centre Charity. We would like to acknowledge the help of all the staff at The David Hide Asthma and Allergy Research Centre in undertaking the assessments of the Isle of Wight birth cohort. We are specifically indebted to the research team including Mr. Stephen Potter, Mrs. Susan Grevatt, Mrs. Gill Glasby, Miss Kaisha Bennett, Mrs. Nicky Tongue and Mrs. Sharon Matthews. Our sincere thanks to the participants and their families who helped us with this project over the last three decades. MAAS Cohort: MAAS was supported by the Asthma UK Grants No 301 (1995–1998), No 362 (1998–2001), No 01/012 (2001–2004), No 04/014 (2004–2007), BMA James Trust (2005) and The JP Moulton Charitable Foundation (2004‐current), The Northwest Lung Centre Charity (1997‐current), the Medical Research Council (MRC) G0601361 (2007–2012), MR/K002449/1 (2013–2014) and MR/L012693/1 (2014–2018), and UNICORN (Unified Cohorts Research Network): Disaggregating asthma MR/S025340/1. ALSPAC Cohort: The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. RG is partially funded by the Wellcome Trust Strategic Award (108,818/15/Z). This publication is the work of the authors, and Raquel Granell and Adnan Custovic will serve as guarantors for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website:(http://www.bristol.ac.uk/alspac/external/documents/grant‐acknowledgements.pdf ). We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses.
Keywords:
allergic sensitisation, asthma, prediction, risk scores, wheeze
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Local EPrints ID: 482296
URI: http://eprints.soton.ac.uk/id/eprint/482296
ISSN: 0105-4538
PURE UUID: c3916c0a-f684-4a51-ba22-2019f702b67d
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Date deposited: 26 Sep 2023 16:38
Last modified: 17 Aug 2024 01:40
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Contributors
Author:
Abdal J. Farhan
Author:
Dilini M. Kothalawala
Author:
Raquel Granell
Author:
Angela Simpson
Author:
Clare Murray
Author:
Adnan Custovic
Author:
Hongmei Zhang
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