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Author Skytt, N.; Bonnelykke, K.; Bisgaard, H. url  doi
  Title “To wheeze or not to wheeze”: That is not the question Type Journal Article
  Year (down) 2012 Publication The Journal of Allergy and Clinical Immunology Abbreviated Journal J Allergy Clin Immunol  
  Volume 130 Issue 2 Pages 403-7.e5  
  Keywords Age of Onset; Ambulatory Care/*statistics & numerical data; Asthma/*diagnosis/epidemiology/physiopathology; Child; Child, Preschool; Denmark/epidemiology; Female; Humans; Infant; Lung/immunology/*physiopathology; Male; Multivariate Analysis; Prognosis; Prospective Studies; Respiratory Function Tests; Respiratory Sounds/*diagnosis/physiopathology; Risk Factors; Severity of Illness Index; Surveys and Questionnaires  
  Abstract BACKGROUND: The diagnosis of asthma in young children is difficult and based on clinical assessment of symptoms and results of physical examination. Respiratory wheeze has traditionally been used to define asthma in young children. OBJECTIVE: We sought to compare the qualitative diagnosis of wheeze with a quantitative global assessment of significant troublesome lung symptoms during the first 3 years of life as a predictor of asthma by age 7 years. METHODS: Children born to asthmatic mothers (n= 411) were followed prospectively to age 7 years. Parents were instructed to visit the research clinic during the first 3 years of life each time the child had significant troublesome lung symptoms for 3 days. At the clinic, a research physician performed a physical examination, including auscultation for wheeze and excluding differential diagnoses. We tested whether wheeze was independently associated with asthma at age 7 years after adjusting for the total number of episodes. RESULTS: Three hundred thirteen children had full follow-up by age 7 years. In a multivariable analysis the total number of acute clinic visits for asthma symptom was significantly associated with later asthma (P< .0001), whereas the presence of wheeze at these visits was not (P= .5). The total number of acute clinic visits for significant troublesome lung symptoms was also significantly associated with later asthma in children who had never presented with any wheeze (P= .03). CONCLUSION: A quantitative global assessment of significant troublesome lung symptoms in the first 3 years of life is a better predictor of asthma than assessment of wheeze. Doctor-diagnosed wheeze is not a prerequisite for the diagnosis of asthma, and relying on the symptom of wheeze will likely be an important cause of undertreatment.  
  Address Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Copenhagen, Denmark  
  Corporate Author Thesis  
  Impact Factor 11,476 First Author Skytt, N. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Bisgaard, H.  
  ISSN 0091-6749 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:22766098 Approved no  
  Call Number Serial 78  
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