infant; childhood; preschool; asthma; wheeze; preschool wheezing disorders; prognosis; classification; phenotypes; longitudinal studies; epidemiology; asthma; children; prediction; epidemiology
Pescatore Anina M, Spycher Ben D, Beardsmore Caroline S, Kuehni Claudia E (2015), "Attacks" or "Whistling": Impact of Questionnaire Wording on Wheeze Prevalence Estimates., in PloS one
, 10(6), 0131618-0131618.
Marshall Lucy, Beardsmore Caroline S, Pescatore Anina M, Kuehni Claudia E, Gaillard Erol A (2015), Airway eosinophils in older teenagers with outgrown preschool wheeze: a pilot study., in The European respiratory journal
, 46(5), 1486-9.
Dogaru Cristian M, Narayanan Manjith, Spycher Ben D, Pescatore Anina M, Owers-Bradley John, Beardsmore Caroline S, Silverman Michael, Kuehni Claudia E (2015), Breastfeeding, lung volumes and alveolar size at school-age., in BMJ open respiratory research
, 2(1), 000081-000081.
Pescatore Anina M., Spycher Ben D., Jurca Maja, Gaillard Erol A., Kuehni Claudia E. (2015), Environmental and socioeconomic data do not improve the Predicting Asthma Risk in Children (PARC) tool, in Journal of Allergy and Clinical Immunology
, 135(5), 1395-1397.
Pescatore Anina, Dogaru Cristian, Duembgen Lutz, Silverman Michael, Gaillard Erol, Spycher Ben, Kuehni Claudia (2014), A simple asthma prediction tool for preschool children with wheeze or cough, in Journal of Allergy and Clinical Immunology
, 133(1), 111-118.
Dogaru Cristian M, Nyffenegger Denise, Pescatore Aniña M, Spycher Ben D, Kuehni Claudia E (2014), Breastfeeding and childhood asthma: systematic review and meta-analysis., in American journal of epidemiology
, 179(10), 1153-67.
Dogaru Cristian M, Nyffenegger Denise, Pescatore Aniña M, Spycher Ben D, Kuehni Claudia E (2014), Dogaru et al. respond to "Does breastfeeding protect against 'asthma'?"
, Oxford University Press, -.
Goutaki Myrofora, Pescatore Anina M., Singh Parvinder, Beardsmore Caroline S., Kuehni Claudia E. (2014), Increased prevalence of pre-school wheeze is not explained by time trends in body mass index, in European Respiratory Journal
, 44(4), 1078-1082.
Spycher Ben, Silverman Michael, Pescatore Anina, Beardsmore Caroline, Kuehni Claudia (2013), Comparison of phenotypes of childhood wheeze and cough in 2 independent cohorts, in Journal of Allergy and Clinical Immunology
, 132(5), 1058-1067.
Strippoli MPF, Spycher BD, Pescatore AM, Beardsmore CS, Silverman M, Kuehni CE (2012), Viral wheezing is virus-specific – not only host-specific (author’s reply)
, European Respiratory Society, Sheffield S10 2PX United Kingdom.
Strippoli M-P F, Spycher B D, Pescatore A M, Beardsmore C S, Silverman M, Kuehni C E (2011), Exclusive viral wheeze and allergic wheeze: evidence for discrete phenotypes., in The European respiratory journal : official journal of the European Society for Clinical Respiratory
, 38(2), 472-4.
Leonardi Nora A, Spycher Ben D, Strippoli Marie-Pierre F, Frey Urs, Silverman Michael, Kuehni Claudia E (2011), Validation of the Asthma Predictive Index and comparison with simpler clinical prediction rules., in The Journal of allergy and clinical immunology
, 127(6), 1466-1466.
Background: Wheezing disorders are the most common chronic health problem in childhood and place a large burden on children, their families and society. There is evidence that wheezing disorders in adults, including asthma and COPD, have their origins in early childhood. Once established, persistent wheeze in children shows strong tracking throughout adolescence and adulthood, a disease process which is accompanied by a decline in lung function and airway remodelling from the first years of life. Knowledge of the main factors leading to the onset of wheezing disorders and to their persistence is a prerequisite for designing interventions to prevent development of the disease, or modify its course early in life. In spite of numerous original papers and systematic reviews on the predictors of wheeze and asthma, these factors are still poorly understood. Previous studies vary greatly in their populations, predictor and outcome definitions, prediction intervals and methodology. What is lacking is a study that systematically assesses the role of a common set of predictors, at different ages, and for different prediction intervals, in a single cohort. Furthermore previous studies have often not discriminated between predictors of onset and predictors of persistence, have paid little attention to phenotypic heterogeneity, and have rarely used alternative statistical methods such as classification and regression trees (CART) and artificial neural networks (ANNs). The Leicester cohorts with their diversity in age spread and recruitment years provide an excellent dataset for such systematic prediction analyses.Aims: This PhD project will focus on the prediction of onset and persistence of childhood wheezing disorders. Specifically the aims are to i) summarise the current evidence of onset and persistence of wheeze and asthma in a systematic review, ii) to identify the important predictors of onset and persistence of childhood wheezing disorders, and iii) to develop simple prognostic tools for use in clinical practice. Methods: In a first step the PhD candidate will systematically search and review the existing literature on predictors of onset and persistence of wheeze and asthma. She or he will then apply methods of prediction to various datasets differing systematically in children’s age at the time of baseline measurements and at assessment of outcomes. All available information at baseline, including pre- and postnatal environmental exposures, hereditary factors, and symptom history will be considered as potential predictors. For these analyses data will be taken from the two Leicester respiratory cohorts. For validation purposes, data from the infant cohorts from Bern and (subject to agreement by individual primary investigators) from cohort studies united in the European Birth Cohort Studies on Allergies and Asthma (GA²LEN) will be used. The PhD candidate will explore and choose from a variety of statistical techniques (regression modelling, classification and regression trees, and artificial neural networks) based on best predictive performance. Based on the results from these prognostic models, the student will then develop simple prognostic tools (scores or decision trees) for use in clinical practice. Again collaboration with the GA2LEN network will be sought for validation of these tools. The PhD project is embedded in ongoing research activities linked to the Leicester cohort studies, particularly studies related to the phenotypic variability of childhood wheezing disorders. The PhD candidate will work closely together with the rest of the team and integrate findings on phenotypic variability into her or his work on prognostic modelling. Significance: By identifying main determinants of onset and persistence of wheeze this project will ultimately contribute to designing interventions for prevention of wheezing disorders in childhood, and for modification of the clinical course once the disease is established. The project will also provide prognostic tools to be used in clinical practice for informed counselling of parents and clinical management.