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Prognostic values of specific respiratory sounds for asthma in adolescents

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Abstract

Childhood wheezing is a common condition associated with asthma, but the term is often misapplied. The present study aimed to investigate the prognostic values of specific respiratory sounds for asthma onset in adolescence. In a prospective study, six specific respiratory sounds were evaluated for their prediction of asthma. Parents were asked for respiratory sounds of their initially asthma-free children and to describe them in specified terms. Self-reported doctor-diagnosed asthma of 1,569 children aged 5 to 14 years from Germany was assessed at baseline and at follow-up for up to 12 years later. Except for ‘ronchus’ (17%), reported ‘gasp’ and ‘whimper’ had the highest positive predictive values of 15% and 11%, respectively. These sounds also showed the greatest increase in asthma incidence (odds ratio = 3.18; 95%CI, 1.46–6.94 and odds ratio = 2.09; 95%CI, 1.00–4.37). It could be shown that from six respiratory sounds, ‘gasp’ and ‘whimper’ were the expressions with the best prediction for asthma onset. This study suggests that parents can sensibly distinguish between respiratory sounds and that it is important to specify breathing sounds, as not all are good predictors for asthma.

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References

  1. Adcock IM, Caramori G, Chung KF (2008) New targets for drug development in asthma. Lancet 372(9643):1073–1087. doi:10.1016/S0140-6736(08) 61449-X

    Article  CAS  PubMed  Google Scholar 

  2. Asher MI, Keil U, Anderson HR et al (1995) International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J 8(3):483–491. doi:10.1183/09031936.95.08030483

    Article  CAS  PubMed  Google Scholar 

  3. Asher MI, Montefort S, Bjorksten B et al (2006) Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet 368(9537):733–743. doi:10.1016/S0140-6736(06) 69283-0

    Article  PubMed  Google Scholar 

  4. Bateman ED, Hurd SS, Barnes PJ et al (2008) Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 31(1):143–178. doi:10.1183/09031936.00138707

    Article  CAS  PubMed  Google Scholar 

  5. Cane RS, Ranganathan SC, McKenzie SA (2000) What do parents of wheezy children understand by “wheeze”? Arch Dis Child 82(4):327–332. doi:10.1136/adc.82.4.327

    Article  CAS  PubMed  Google Scholar 

  6. Cane RS, McKenzie SA (2001) Parents′ interpretations of children's respiratory symptoms on video. Arch Dis Child 84(1):31–34. doi:10.1136/adc.84.1.31

    Article  CAS  PubMed  Google Scholar 

  7. Castro-Rodriguez JA, Holberg CJ, Wright AL et al (2000) A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med 162(4 Pt 1):1403–1406

    CAS  PubMed  Google Scholar 

  8. Dodge R, Martinez FD, Cline MG et al (1996) Early childhood respiratory symptoms and the subsequent diagnosis of asthma. J Allergy Clin Immunol 98(1):48–54. doi:10.1016/S0091-6749(96) 70225-7

    Article  CAS  PubMed  Google Scholar 

  9. Elphick HE, Ritson S, Rodgers H et al (2000) When a “wheeze” is not a wheeze: acoustic analysis of breath sounds in infants. Eur Respir J 16(4):593–597. doi:10.1034/j.1399-3003.2000.16d04.x

    Article  CAS  PubMed  Google Scholar 

  10. Elphick HE, Sherlock P, Foxall G et al (2001) Survey of respiratory sounds in infants. Arch Dis Child 84(1):35–39. doi:10.1136/adc.84.1.35

    Article  CAS  PubMed  Google Scholar 

  11. Gross V, Reinke C, Dette F et al (2007) Mobile nocturnal long-term monitoring of wheezing and cough. Biomed Tech (Berl) 52(1):73–76. doi:10.1515/BMT.2007.014

    Article  Google Scholar 

  12. Hederos CA, Hasselgren M, Hedlin G et al (2007) Comparison of clinically diagnosed asthma with parental assessment of children's asthma in a questionnaire. Pediatr Allergy Immunol 18(2):135–141. doi:10.1111/j.1399-3038.2006.00474.x

    Article  PubMed  Google Scholar 

  13. Heinrich J, Hoelscher B, Frye C et al (2002) Improved air quality in reunified Germany and decreases in respiratory symptoms. Epidemiology 13(4):394–401. doi:10.1097/00001648-200207000-00006

    Article  PubMed  Google Scholar 

  14. Heinrich J, Hoelscher B, Wichmann HE (2000) Decline of ambient air pollution and respiratory symptoms in children. Am J Respir Crit Care Med 161(6):1930–1936

    CAS  PubMed  Google Scholar 

  15. Heinrich J, Hoelscher B, Wjst M et al (1999) Respiratory diseases and allergies in two polluted areas in East Germany. Environ Health Perspect 107(1):53–62. doi:10.2307/3434289

    Article  CAS  PubMed  Google Scholar 

  16. Holden DA, Mehta AC (1990) Evaluation of wheezing in the nonasthmatic patient. Clevel Clin J Med 57(4):345–352

    CAS  Google Scholar 

  17. Janson C, Anto J, Burney P et al (2001) The European Community Respiratory Health Survey: what are the main results so far? European Community Respiratory Health Survey II. Eur Respir J 18(3):598–611. doi:10.1183/09031936.01.00205801

    Article  CAS  PubMed  Google Scholar 

  18. Kurukulaaratchy RJ, Fenn MH, Waterhouse LM et al (2003) Characterization of wheezing phenotypes in the first 10 years of life. Clin Exp Allergy 33(5):573–578. doi:10.1046/j.1365-2222.2003.01657.x

    Article  CAS  PubMed  Google Scholar 

  19. Lai CK, Chan JK, Chan A et al (1997) Comparison of the ISAAC video questionnaire (AVQ3.0) with the ISAAC written questionnaire for estimating asthma associated with bronchial hyperreactivity. Clin Exp Allergy 27(5):540–545. doi:10.1111/j.1365-2222.1997.tb00742.x

    Article  CAS  PubMed  Google Scholar 

  20. Lowe L, Murray CS, Martin L et al (2004) Reported versus confirmed wheeze and lung function in early life. Arch Dis Child 89(6):540–543. doi:10.1136/adc.2003.038539

    Article  CAS  PubMed  Google Scholar 

  21. Martinez FD, Wright AL, Taussig LM et al (1995) Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med 332(3):133–138. doi:10.1056/NEJM199501193320301

    Article  CAS  PubMed  Google Scholar 

  22. Meslier N, Charbonneau G, Racineux JL (1995) Wheezes. Eur Respir J 8(11):1942–1948. doi:10.1183/09031936.95.08111942

    Article  CAS  PubMed  Google Scholar 

  23. Pekkanen J, Sunyer J, Anto JM et al (2005) Operational definitions of asthma in studies on its aetiology. Eur Respir J 26(1):28–35. doi:10.1183/09031936.05.00120104

    Article  CAS  PubMed  Google Scholar 

  24. Piippo-Savolainen E, Korppi M (2008) Wheezy babies—wheezy adults? Review on long-term outcome until adulthood after early childhood wheezing. Acta Paediatr 97(1):5–11. doi:10.1111/j.1651-2227.2007.00558.x

    Article  PubMed  Google Scholar 

  25. Rothman KE (1986) Modern epidemiology. Little Brown & Co., Boston

    Google Scholar 

  26. Rzehak P, Schoefer Y, Wichmann HE et al (2008) A prospective study on the association between hay fever among children and incidence of asthma in East Germany. Eur J Epidemiol 23(1):17–22. doi:10.1007/s10654-007-9205-3

    Article  PubMed  Google Scholar 

  27. Shapiro GG (2006) Among young children who wheeze, which children will have persistent asthma? J Allergy Clin Immunol 118(3):562–564. doi:10.1016/j.jaci.2006.07.011

    Article  PubMed  Google Scholar 

  28. Taussig LM, Wright AL, Holberg CJ et al (2003) Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Immunol 111(4):661–675. doi:10.1067/mai.2003.162

    Article  PubMed  Google Scholar 

  29. Turner SW, Craig L, Harbour P et al (2008) Early rattles, purrs and whistles as predictors of later wheeze. Arch Dis Child 93:701–704. doi:10.1136/adc.2007.134569

    Article  CAS  PubMed  Google Scholar 

  30. von Mutius E, Fritzsch C, Weiland SK et al (1992) Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison. BMJ 305(6866):1395–1399

    Article  Google Scholar 

  31. Weiland SK, Kugler J, von Mutius E (1993) [The language of pediatric asthma patients. A study of symptom description]. Monatsschr Kinderheilkd 141(11):878–882

    CAS  PubMed  Google Scholar 

  32. Weiland SK, von Mutius E, Hirsch T et al (1999) Prevalence of respiratory and atopic disorders among children in the East and West of Germany five years after unification. Eur Respir J 14(4):862–870. doi:10.1034/j.1399-3003.1999.14d23.x

    Article  CAS  PubMed  Google Scholar 

  33. Weiland SK, von Mutius E, Keil U (1999) [The International Study on Asthma and Allergies in Childhood (ISAAC)]. Allergologie 22(5):275–282

    Google Scholar 

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Acknowledgements

The authors would like to thank all the parents and children who participated, the study group of the Bittefeld Study, and G. Woelke for the organisation of the 12-year follow-up. The field work of this study was supported exclusively by a governmental funding source, the Federal Environmental Agency (Umweltbundesamt) grant numbers 11609002, 116002/02 and 29861724.

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The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Institute of Medical Data Management, Biometrics and Epidemiology, Ludwig Maximilians University, Marchioninistrasse 15, 81577, Munich, Germany

    Theresa Hunger, Peter Rzehak & H.-Erich Wichmann

  2. Institute of Epidemiology, Helmholtz Zentrum Munich–German Research Center for Environmental Health, Ingolstaedter Landstrasse 1, 85746, Neuherberg, Germany

    Theresa Hunger, Peter Rzehak, H.-Erich Wichmann & Joachim Heinrich

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  1. Theresa Hunger
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  2. Peter Rzehak
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  4. Joachim Heinrich
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Correspondence to Joachim Heinrich.

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Hunger, T., Rzehak, P., Wichmann, HE. et al. Prognostic values of specific respiratory sounds for asthma in adolescents. Eur J Pediatr 169, 39–46 (2010). https://doi.org/10.1007/s00431-009-0976-2

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  • DOI: https://doi.org/10.1007/s00431-009-0976-2

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