70 High Dose Vitamin D for the Prevention of Wheezing in Preschoolers: A Secondary Analysis of a Randomized Clinical Trial
Notice bibliographique
Résumé
Wheeze is a common condition affecting nearly one in three preschool children with few effective preventive interventions. Observational studies have suggested that vitamin D may improve lung function in children and adults, though no trial has examined whether a high dose of vitamin D supplementation can prevent wheezing in healthy preschool children. This study aimed to determine whether high dose vitamin D supplementation could reduce wheezing in young healthy children compared to a standard dose of vitamin D supplementation. This study was a prespecified secondary analysis of a 1:1 parallel, multicenter, superiority randomized clinical trial. The trial was conducted through a large primary care research network in Toronto, ON. Children with health conditions affecting growth, chronic condition(s) except for asthma, severe developmental delays, and children with gestational age < 32 weeks were excluded. Healthy children age 1 to 5 years were randomized to either ‘standard-dose’ (400IU/day) or ‘high-dose’ (2000IU/day) orally supplemented vitamin D. Parents administered 1 drop/day of the assigned formulation (Kids Ddrops containing vitamin D3) to their child between time of enrolment (September-November) until follow-up (April-June). The outcome for this prespecified secondary analysis was one or more wheezing episode ascertained monthly by telephone. A binomial regression model was used to obtain the relative risk of one or more wheezing episodes in the high-dose group compared to the standard-dose group with 95% confidence intervals. Between September 2011 and June 2015, 703 children were recruited of which 631 (89.6%) provided data on wheezing. Mean age was 2.03 years and 57% were male. At baseline, 17 % of children in the high-dose group and 15 % of children in the standard-dose group had serum 25-hydroxyvitamin D levels below 75 nmol/L. Wheezing in the past was reported at baseline by 22% in the high-dose group and 20% in the standard-dose group. One or more wheezing episodes occurred in 16% of participants in the high-dose group and 12% of participants in the standard-dose group over the winter season which was not statistically different (RR=1.38, 95% CI: 0.93, 2.07, p=0.12). In this randomized clinical trial of healthy young children, the risk of wheezing was not reduced by high-dose vitamin D compared to standard-dose supplementation. These results are consistent with several observational studies of vitamin D supplementation and wheeze in childhood. The trial was conducted across multiple sites, enhancing the generalizability of results. This study was limited by parent-reported outcomes, though gold standard tests for wheeze (e.g. spirometry) are challenging to perform in young children.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,007 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».