Non-invasive test could easily detect asthma in preschool children

MONDAY, Oct. 10, 2022 (HealthDay News) — An infant’s first wheeze can be scary for new parents, as wheezing is known to increase a child’s risk of asthma.

There hasn’t been an easy way to predict that a child will actually develop the respiratory disease without conducting invasive testing, but now a short questionnaire can do just that.

In a new study, CHART (Childhood Asthma Risk Tool) identified 91% of 3-year-olds who continued to have wheezing and other asthma symptoms through age 5, beating physician diagnoses and the standard modified asthma predictive index, which is invasive testing requires.

CHART asks a series of questions about wheezing and coughing over the past year. It is to be answered by parents every six months after a child’s first birthday. The questionnaire also accounts for visits to the emergency room, hospitalizations for wheezing or asthma, and use of medications for wheezing, cough, and other symptoms that increase the risk of asthma.

“If they fall into the high-risk category, this alerts the physician that the patient will likely continue to have symptoms and health care and therefore require further evaluation for therapy,” said study author Dr. Padmaja Subbarao, associate director of clinical research at the Hospital for Sick Children in Toronto.

For the study, the researchers compared CHART’s ability to predict asthma risk with other available methods in more than 2,500 children. CHART was more accurate than doctors, who identified 62% of children likely to still have symptoms by age 5, and the current test, which was correct 48.5% of the time.

The results were released on October 6th JAMA network open.

Experts have expressed mixed views about the potential value of this new asthma screening test in young children.

“CHART has excellent applicability, in my opinion,” said Dr. Rebecca Fisk, a pediatrician at Lenox Hill Hospital in New York City. “This is an excellent non-invasive tool to target the care and management of these children in a busy pediatric office or primary care clinic, where rapid identification of those most at risk for proper asthma therapy and the delivery of treatments and utilization of the… healthcare is paramount.”

This information can be easily gathered to quickly identify high-risk children and allows doctors to monitor intermediate- to low-risk children as well, she said.

CHART can be used to predict and prevent emergency department visits and hospitalizations for asthma in children if it ensures appropriate and early management and management of asthma, Fisk said.

But dr Shilpa Patel, medical director of the IMPACT DC Asthma Clinic at Children’s National in Washington, DC, pointed out that the available screening tools work well without invasive testing.

“There is a place for CHART, but there are other tools,” she said.

Regardless of which screening method is used, it’s important to diagnose asthma early and start treatment, she said.

“Although asthma is a chronic and common respiratory disease in children, it’s treatable and doesn’t mean kids have to be on medication forever,” she said. Treatment will be reviewed every three to six months in relation to what is happening with your child, she explained.

dr Nathan Rabinovitch, an allergist and director of the pediatric care unit at National Jewish Health in Denver, said the real question is whether the child is still wheezing at age 8, and the new study doesn’t provide that information.

Children who also have allergies are most likely to develop asthma, he said.

“If a child has outdoor or indoor allergies, or [the inflammatory skin condition] Eczema, this is a pretty strong predictor of asthma risk,” he noted.

There are ways to reduce the risk of allergic reactions that can trigger an asthma attack in children, such as: B. Ensuring your child isn’t exposed to secondhand smoke and taking steps to eliminate exposure to other known allergens like dust mites, he said.

More information

The American College of Allergy, Asthma & Immunology has more information on treating asthma in children.

SOURCES: Padmaja Subbarao, MD, MSc, Associate Chief, Clinical Research, The Hospital for Sick Children, and Co-Lead, Precision Child Health, Toronto, Ontario, Canada; Rebecca Fisk, MD, pediatrician, Lenox Hill Hospital, New York City; Shilpa Patel, MD, MPH, Medical Director, IMPACT DC Asthma Clinic, Children’s National, Washington, DC; Nathan Rabinovitch, MD, MPH, Allergist, Director, Children’s Ward, National Jewish Health, Denver; JAMA network openOctober 6, 2022