The Healthcare Burden of Pediatric Cough and Associations With Preschool Asthma – Findings from the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study
Notice bibliographique
Résumé
Abstract Rationale: Asthma is the most common chronic airway disease among preschool-aged children and carries a high healthcare burden in terms of unplanned healthcare visits, medication-use and lower health-related quality of life. Although cough is a clinically relevant symptom of childhood asthma, current prediction tools focus on wheeze as its primary indicator, and there is conflicting literature regarding the healthcare burden of cough. We evaluated the association between cough features and asthma, and its healthcare burden among Canadian preschool-aged children with/without coexisting wheeze. Methods: Data from the CHILD Cohort Study, a prospective, longitudinal general-population Canadian birth cohort study was used. Information on presence, duration, severity, and frequency of cough without cold, wheeze, unscheduled doctor visits (UDVs), hospital visits (HVs) and use of bronchodilators (BD), inhaled corticosteroids (ICS), and oral corticosteroids (OCS) in the first 5-years of life were obtained via parent-reported questionnaires and in-person clinical assessments. Longitudinal associations between cough and healthcare/medication-use outcomes were estimated via repeated measures generalized estimation equations, using data collected during infancy (birth to 12-months) and preschool (>12months to 5-years). Models were adjusted for breastfeeding duration, sex, smoke exposure, maternal asthma, study site, family income and preschool asthma diagnosis. Results: Of 3,042 participants during the infancy period, 324 (10.6%) had cough without cold, and 737 (24.2%) had wheeze. Of 2,822 participants during preschool visits, 288 (10.2%) had cough and 703 (24.9%) had wheeze. In infancy, cough was significantly associated with increased UDVs, HVs, and OCS-use. Compared to cough, infants with wheeze had stronger association with UDVs, HVs, ICS and BD-use. Notably, both cough [adjusted odds ratio: 1.39 (95% confidence interval: 1.01 – 1.93)] and wheeze [1.45 (1.14 – 1.84)] were associated with OCS-use. Moreover, infants with cough ≥4 days were 74% more likely to require UDVs, and those with moderate-severe cough (i.e. cough disturbs daily activities/sleep) were at least twice as likely to require UDVs, HVs and OCS-use (Table). In preschool, odds of UDVs, HVs, ICS and BD were increased in children with cough and further increased in those with wheeze. Nonetheless, preschoolers exhibiting cough ≥4 days, or moderate-severe cough were significantly associated with increased UDVs, HVs, ICS-use and BD-use independent of wheeze (Table). Conclusions: Cough without cold, even in the absence of wheeze, carries a high healthcare utilization burden from infancy throughout preschool, and its relationship to asthma medication-use demonstrates a need to re-evaluate treatment plans among non-wheezing children with cough ≥4 days or moderate-severe cough.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
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 | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
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 ».