Validating an asthma case detection instrument in a Head Start sample.

Full Abstract

Although specific tests screen children in preschool programs for vision, hearing, and dental conditions, there are no published validated instruments to detect preschool-age children with asthma, one of the most common pediatric chronic conditions affecting children in economically disadvantaged communities of color. As part of an asthma education intervention, a 15-item Brief Respiratory Questionnaire (BRQ) was developed to detect children with probable asthma in Head Start and subsidized preschool settings in communities with high asthma prevalence and associated morbidity. Preschool personnel administered the BRQ to consenting parents of 419 enrolled children. Trained interviewers administered validation interviews (VALs) to parents of 149 case-positive children and 51 case-negative children. Three physicians independently assessed deidentified summaries of the VALs that captured responses about signs and symptoms of asthma, diagnosis and treatment, and use of medical services. The physicians' assessments of the summarized VALs were the validated standard to which the BRQ classifications were compared. A simple algorithm of 4 items was identified that can be administered and scored by nonmedical preschool personnel in less than 5 minutes. The chance-corrected agreement between these 4 items of the BRQ and the VAL was good:
kappa, .73 (95% confidence interval, 0.62-0.84); specificity, 96%; sensitivity, 73%; and positive predictive value, 97%. The BRQ appears to be a valid instrument for detecting children with probable asthma in Head Start and other subsidized preschool settings in communities with high prevalence of asthma.

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Author information

Author/s: Bonner, Sebastian (S); Matte, Thomas (T); Rubin, Mitchell (M); Sheares, Beverley J (BJ); Fagan, Joanne K (JK); Evans, David (D); Mellins, Robert B (RB);

Affiliation: Center for Urban Epidemiologic Studies, New York City Department of Health and Mental Hygiene, New York, NY 10029, USA. sbonner(-atsign-)nyam.org

Journal and publication information

Publication Type: Journal Article; Validation Studies

Journal: The Journal of school health (J Sch Health), published in United States. (Language: eng)

Reference: 2006-Nov; vol 76 (issue 9) : pp 471-8

Dates: Created 2006/10/09; Completed 2007/02/01; Revised 2007/11/15;

PMID: 17026641, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Allergens
Asthma - diagnosis; physiopathology; prevention & control
Child, Preschool
Early Intervention (Education) - methods
Environmental Exposure
Humans
Interviews as Topic

Associated Chemicals: Allergens (0)

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