Predictive Value of Impulse Oscillometry Combined with Fractional Expiratory Nitric Oxide Test for Asthma in Preschool Children.

IF 3.7 3区医学 Q2 ALLERGY

Journal of Asthma and Allergy Pub Date : 2024-05-08 eCollection Date: 2024-01-01 DOI:10.2147/JAA.S460193

Junsong Chen, Jiying Xiao, Lingyue Liu, Kamran Ali, Suling Wu

{"title":"Predictive Value of Impulse Oscillometry Combined with Fractional Expiratory Nitric Oxide Test for Asthma in Preschool Children.","authors":"Junsong Chen, Jiying Xiao, Lingyue Liu, Kamran Ali, Suling Wu","doi":"10.2147/JAA.S460193","DOIUrl":null,"url":null,"abstract":"Objective: Prediction of asthma in preschool children is challenging and lacks objective indicators. The aim is to observe and analyze the variances between impulse oscillometry (IOS) and fractional expiratory nitric oxide (FeNO) in preschool children with wheezing, establish a joint prediction model, and explore the diagnostic value of combining IOS with FeNO in diagnosing asthma among preschool children.Patients and methods: This study enrolled children aged 3-6 years with wheezing between June 2021 and June 2022. They were categorized as asthmatic (n=104) or non-asthmatic (n=109) after a 1-year follow-up. Clinical data, along with IOS and FeNO measurements from both groups, underwent univariate regression and multiple regression analyses to identify predictive factors and develop the most accurate model. The prediction model was built using the stepwise (stepAIC) method. The receiver operating characteristic curve (ROC), calibration curve, Hosmer-Lemeshow test, and decision curve analysis (DCA) were employed to validate and assess the model.Results: During univariate analysis, a history of allergic rhinitis, a history of eczema or atopic dermatitis, and measures including FeNO, R5, X5, R20, Fres, and R5-R20 were found to be associated with asthma diagnosis. Subsequent multivariate analysis revealed elevated FeNO, R5, and X5 as independent risk factors. The stepAIC method selected five factors (history of allergic rhinitis, history of eczema or atopic dermatitis, FeNO, R5, X5) and established a prediction model. The combined model achieved an AUROC of 0.94, with a sensitivity of 0.89 and specificity of 0.88, surpassing that of individual factors. Calibration plots and the HL test confirmed satisfactory accuracy.Conclusion: This study has developed a prediction model based on five factors, potentially aiding clinicians in early identification of asthma risk among preschool children.","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"421-430"},"PeriodicalIF":3.7000,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11088859/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Asthma and Allergy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JAA.S460193","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Prediction of asthma in preschool children is challenging and lacks objective indicators. The aim is to observe and analyze the variances between impulse oscillometry (IOS) and fractional expiratory nitric oxide (FeNO) in preschool children with wheezing, establish a joint prediction model, and explore the diagnostic value of combining IOS with FeNO in diagnosing asthma among preschool children.

Patients and methods: This study enrolled children aged 3-6 years with wheezing between June 2021 and June 2022. They were categorized as asthmatic (n=104) or non-asthmatic (n=109) after a 1-year follow-up. Clinical data, along with IOS and FeNO measurements from both groups, underwent univariate regression and multiple regression analyses to identify predictive factors and develop the most accurate model. The prediction model was built using the stepwise (stepAIC) method. The receiver operating characteristic curve (ROC), calibration curve, Hosmer-Lemeshow test, and decision curve analysis (DCA) were employed to validate and assess the model.

Results: During univariate analysis, a history of allergic rhinitis, a history of eczema or atopic dermatitis, and measures including FeNO, R5, X5, R20, Fres, and R5-R20 were found to be associated with asthma diagnosis. Subsequent multivariate analysis revealed elevated FeNO, R5, and X5 as independent risk factors. The stepAIC method selected five factors (history of allergic rhinitis, history of eczema or atopic dermatitis, FeNO, R5, X5) and established a prediction model. The combined model achieved an AUROC of 0.94, with a sensitivity of 0.89 and specificity of 0.88, surpassing that of individual factors. Calibration plots and the HL test confirmed satisfactory accuracy.

Conclusion: This study has developed a prediction model based on five factors, potentially aiding clinicians in early identification of asthma risk among preschool children.

查看原文本刊更多论文

脉冲振荡仪结合分量呼气一氧化氮测试对学龄前儿童哮喘的预测价值

目的：学龄前儿童哮喘的预测具有挑战性，且缺乏客观指标。本研究旨在观察和分析学龄前喘息儿童脉冲振荡仪（IOS）与呼气一氧化氮分数（FeNO）之间的差异，建立联合预测模型，并探讨IOS与FeNO结合在学龄前儿童哮喘诊断中的诊断价值：本研究招募了 2021 年 6 月至 2022 年 6 月期间患有喘息的 3-6 岁儿童。随访一年后，他们被分为哮喘（104 人）和非哮喘（109 人）。对两组患者的临床数据以及 IOS 和 FeNO 测量结果进行了单变量回归和多元回归分析，以确定预测因素并建立最准确的模型。预测模型采用逐步法（stepAIC）建立。采用接收者操作特征曲线（ROC）、校准曲线、Hosmer-Lemeshow 检验和决策曲线分析（DCA）来验证和评估模型：单变量分析发现，过敏性鼻炎病史、湿疹或特应性皮炎病史以及 FeNO、R5、X5、R20、Fres 和 R5-R20 等指标与哮喘诊断相关。随后的多变量分析显示，FeNO、R5 和 X5 的升高是独立的风险因素。StepAIC 方法选择了五个因素（过敏性鼻炎病史、湿疹或特应性皮炎病史、FeNO、R5、X5），并建立了一个预测模型。综合模型的 AUROC 为 0.94，灵敏度为 0.89，特异度为 0.88，超过了单个因素的预测结果。校准图和 HL 检验证实了其令人满意的准确性：本研究建立了一个基于五个因素的预测模型，可帮助临床医生早期识别学龄前儿童的哮喘风险。

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分钟内获得全文求助全文

来源期刊

Journal of Asthma and Allergy Medicine-Immunology and Allergy

CiteScore

5.30

自引率

6.20%

发文量

185

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal publishing original research, reports, editorials and commentaries on the following topics: Asthma; Pulmonary physiology; Asthma related clinical health; Clinical immunology and the immunological basis of disease; Pharmacological interventions and new therapies. Although the main focus of the journal will be to publish research and clinical results in humans, preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies.