Oscillometry to support clinical assessment in asthmatic preschoolers: Real-life impact - 04/03/23
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Abstract |
In preschoolers, asthma control is assessed clinically using history and physical examination. In certain centres, oscillometry is used to support clinical assessment; yet its clinical utility for asthma management remains to be quantified. The objectives were to determine if oscillometry, as adjunct to clinical assessment, influences asthma assessment, management and control, compared to clinical assessment alone in preschoolers.
We conducted a cross-sectional study in children aged 3–5 years with a confirmed asthma diagnosis. Oscillometry-tested preschoolers were matched by propensity score to untested children. The co-primary outcomes, the likelihood of a persistent asthma phenotype and a maintenance therapy prescription at the index visit, were examined by multivariable logistic regression. Asthma control over the next year was examined by cumulative logistic regression in the nested retrospective cohort with available drug claim data.
The cohort comprised 726 (249 oscillometry-tested; 477 untested) children with 57.4% male (median age: 4.6 years). Propensity score matching resulted in comparable groups. Compared to controls, oscillometry-tested children were more frequently labelled with a persistent phenotype (67% vs. 50%; adjusted OR [95% CI]: 2.34 [1.66–3.34]) with no significant difference in maintenance therapy prescription (65% vs. 58%; 1.37 [0.98–1.92]); but experienced a lower likelihood of poor control over the next year (adjusted OR [95% CI]: 0.24 [0.08–0.74]).
The association between the addition of oscillometry to clinical assessment with more persistent phenotype labelling and better asthma control supports its clinical utility; no significant impact on maintenance therapy prescription was observed at the index visit.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Oscillometry, a lung function test, is feasible and reproducible in preschoolers. |
• | Oscillometry was tested as adjunct to clinical assessment in young children. |
• | Its use increased persistent phenotype labelling and subsequent asthma control. |
• | Its use didn't significantly increase already high maintenance therapy prescription. |
• | Its responsiveness, more than discrimination, properties may explain its utility. |
Abbreviations : ICS, OS, MCH, SJUHC, MED-ECHO, RAMQ, reMED, ICD-9, ICD-10, PPACI, SABA, OCS, ED, Rx, Xy, AX, OR
Plan
☆ | This work was funded by the Academic Chair in Clinical Research and Knowledge Transfer Unit on Childhood Asthma of the Research Centre at the Sainte-Justine University Hospital Centre, as well as scholarship from the Canadian Institutes of Health Research, the Fonds de recherche du Québec – Santé, and the University of Montreal. |
Vol 209
Article 107148- avril 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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