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T-Space at The University of Toronto Libraries >
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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/32502

Title: The Accuracy of Epidemiologic Definitions of Childhood Asthma Using a Clinical Reference Standard
Authors: Yang, Connie
Advisor: Dell, Sharon
Department: Medical Science
Keywords: Asthma
Epidemiology
Diagnosis
Pediatric
Administrative database
Questionnaire
Issue Date: 24-Jul-2012
Abstract: This study determined the sensitivity and specificity of questionnaires and administrative databases compared to a clinical reference standard for asthma. 208 schoolchildren from a population-based sample participated. They underwent a physician assessment, spirometry, methacholine challenge, exhaled nitric oxide and skin testing. Data was linked to the Ontario Asthma Surveillance Information System. “Questionnaire diagnosis” was an affirmative response to physician-diagnosed asthma. “Database diagnosis” was 2 outpatient visits or 1 hospitalization within 2 years. “Clinical diagnosis” required a physician assessment and objective findings of asthma. “Questionnaire diagnosis” of asthma was specific (92.1%) but not sensitive (75.3%) compared to the “clinical diagnosis”. “Database diagnosis” was sensitive (87.5%) but not specific (64.8%). Both sources had an excellent negative predictive value (97-98%) but poor positive predictive value (24-55%). Epidemiologic methods accurately identify those without asthma but are poor at identifying those with asthma, leading to an overestimation of asthma prevalence and dilution of risk estimates.
URI: http://hdl.handle.net/1807/32502
Appears in Collections:Master

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