当前位置: X-MOL 学术Pediatr. Allergy Immunol. Pulmonol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Asthma Screening in Pediatric Sickle Cell Disease: A Clinic-Based Program Using Questionnaires and Spirometry.
Pediatric Allergy, Immunology, and Pulmonology ( IF 0.9 ) Pub Date : 2017-12-28 , DOI: 10.1089/ped.2017.0776
Sara C Sadreameli 1 , Rachel O Alade 2 , Peter J Mogayzel 1 , Sharon McGrath-Morrow 1 , John J Strouse 2
Affiliation  

A clinician diagnosis of asthma is associated with increased morbidity and mortality in people with sickle cell disease (SCD). We hypothesized that a screening program would help identify children with asthma needing referral to pulmonary clinic. We conducted a single-center project to screen patients with SCD for asthma using a previously validated questionnaire (Breathmobile) and for pulmonary function abnormalities with portable spirometry. Participants with a positive questionnaire and/or abnormal spirometry were referred to pediatric pulmonary clinic. We evaluated clinical associations with abnormal spirometry and questionnaire responses. Of the 157 participants, 58 (37%) had a positive asthma screening questionnaire. Interpretable spirometry was available for 105 (83% of those eligible) and of these, 35 (34%) had abnormal results. The asthma questionnaire was 87.5% sensitive [95% confidence interval (CI) 74.8-95.3] and 85.3% specific (95% CI 77.3-91.4) to detect a clinician diagnosis of asthma. Participants with positive questionnaires were older (mean age 12.2 vs. 9.9 years, P = 0.012). Spirometry identified 16 additional participants who had normal asthma questionnaires. Seventy-four participants (47%) were referred to pediatric pulmonary clinic and 25 (34%) of these participants scheduled clinic appointments; however, only 13 (52%) were evaluated in pulmonary clinic. Clinic-based asthma screening and spirometry frequently identified individuals with asthma and pulmonary function abnormalities. Only 22% of those referred were eventually seen in pulmonary clinic. The impact of improved screening and treatment on the pulmonary morbidity in SCD needs to be defined and is an area for future investigation. In addition, case management or multidisciplinary clinics may enhance future screening programs.

中文翻译:

小儿镰状细胞病的哮喘筛查:使用问卷和肺量计的基于临床的程序。

临床诊断为哮喘与镰状细胞病(SCD)患者的发病率和死亡率增加有关。我们假设筛查程序将有助于识别需要转诊至肺科诊所的哮喘儿童。我们进行了一个单中心项目,以使用先前验证的问卷(Breathmobile)对SCD患者进行哮喘筛查,并通过便携式肺活量测定法筛查肺功能异常。问卷调查阳性和/或肺活量测定异常的参与者被转诊至小儿肺科诊所。我们评估了肺功能异常和问卷反应的临床关联。在157名参与者中,有58名(37%)的哮喘筛查问卷呈阳性。可解释的肺活量测定可用于105名(占合格者的83%),其中35名(34%)有异常结果。哮喘调查表的敏感性为87.5%[95%置信区间(CI)74.8-95.3],特异性为85.3%(95%CI 77.3-91.4),以检测临床医生对哮喘的诊断。问卷正面的参与者年龄较大(平均年龄12.2比9.9岁,P = 0.012)。肺活量测定法又确定了16名哮喘病问卷正常的参与者。七十四名参与者(47%)被转诊至儿科肺科诊所,其中25名参与者(34%)安排了预约门诊;但是,在肺部诊所仅评估了13个(52%)。基于临床的哮喘筛查和肺活量测定法经常发现患有哮喘和肺功能异常的个体。最终,只有22%的转诊者在肺部诊所就诊。需要确定改进的筛查和治疗对SCD肺部疾病的影响,这是未来研究的一个领域。此外,病例管理或多学科诊所可能会增强未来的筛查程序。
更新日期:2019-11-01
down
wechat
bug