Validation of childhood asthma predictive tools: A systematic review
File(s)
Author(s)
Colicino, Silvia
Munblit, Daniel
Minelli, Cosetta
Custovic, Adnan
Cullinan, Paul
Type
Journal Article
Abstract
BACKGROUND: There is uncertainty about the clinical usefulness of currently available asthma predictive tools. Validation of predictive tools in different populations and clinical settings is an essential requirement for the assessment of their predictive performance, reproducibility and generalizability. We aimed to critically appraise asthma predictive tools which have been validated in external studies. METHODS: We searched MEDLINE and EMBASE (1946-2017) for all available childhood asthma prediction models and focused on externally validated predictive tools alongside the studies in which they were originally developed. We excluded non-English and non-original studies. PROSPERO registration number is CRD42016035727. RESULTS: From 946 screened papers, eight were included in the review. Statistical approaches for creation of prediction tools included chi-square tests, logistic regression models and the least absolute shrinkage and selection operator. Predictive models were developed and validated in general and high-risk populations. Only three prediction tools were externally validated: the Asthma Predictive Index, the PIAMA and the Leicester asthma prediction tool. A variety of predictors has been tested, but no studies examined the same combination. There was heterogeneity in definition of the primary outcome among development and validation studies, and no objective measurements were used for asthma diagnosis. The performance of tools varied at different ages of outcome assessment. We observed a discrepancy between the development and validation studies in the tools' predictive performance in terms of sensitivity and positive predictive values. CONCLUSIONS: Validated asthma predictive tools, reviewed in this paper, provided poor predictive accuracy with performance variation in sensitivity and positive predictive value.
Date Issued
2019-04
Date Acceptance
2018-12-06
Citation
Clinical and Experimental Allergy, 2019, 49 (4), pp.410-418
ISSN
0954-7894
Publisher
Wiley
Start Page
410
End Page
418
Journal / Book Title
Clinical and Experimental Allergy
Volume
49
Issue
4
Copyright Statement
© 2019 John Wiley & Sons Ltd. This is the accepted version of the following article: Colicino S, Munblit D, Minelli C, Custovic A, Cullinan P. Validation of childhood asthma predictive tools: A systematic review. Clin Exp Allergy. 2019;00:1–9., which has been published in final form at https://dx.doi.org/10.1111/cea.13336
Sponsor
Colt Foundation
Medical Research Council (MRC)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30657220
Grant Number
CF/04/16
MR/K002449/2
Subjects
Science & Technology
Life Sciences & Biomedicine
Allergy
Immunology
DIAGNOSTIC-TEST
PRESCHOOL-CHILDREN
SPECTRUM BIAS
PRIMARY-CARE
RISK
MODELS
PHENOTYPES
ACCURACY
DISEASE
IGE
1107 Immunology
1117 Public Health and Health Services
Allergy
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2019-01-18