Prevalence of allergic bronchopulmonary aspergillosis and Aspergillus sensitization in asthmatic children: A systematic review and meta-analysis
Bibliographic record
Abstract
Background: Uncontrolled asthma is a significant problem in children. A subset of such children may develop allergic bronchopulmonary aspergillosis (ABPA). ABPA is often preceded by Aspergillus sensitization (AS). There is a scarcity of data on the prevalence of AS and ABPA in asthmatic children. Objectives: We undertook a systematic review and meta-analysis of the prevalence of AS and ABPA in asthmatic children, to develop an evidence-based guideline recommendation on whether children with difficult-to-control asthma should be investigated for ABPA. Methods: The authors searched PubMed and the Cochrane Library for observational studies describing the prevalence or incidence of ABPA and/or AS in asthmatic patients. We included both pediatric and adult studies being aware of the paucity of studies in children. We assessed the quality of included studies using the Newcastle–Ottawa Scale modified for cross-sectional studies. Our primary outcome measure was the prevalence of AS and ABPA in asthmatic children. Secondary outcome measures included the prevalence of AS and ABPA in adults with asthma. We conducted a meta-analysis of the prevalence of AS and ABPA, using the random-effects model. Results: We identified a total of 72 records reporting the prevalence of AS or ABPA (children = 11, adults = 44, and children and adults = 17). About two-thirds of the studies in children were of good quality. The overall pooled prevalence of AS in children was 27% (95% confidence interval [CI]: 18%, 37%), and it was significantly higher in studies including children with severe asthma (41% [95% CI: 25%, 56%]). The overall prevalence of ABPA in children was 19% (95% CI: 11%, 27%), and it was not different by asthma severity, although the number of studies was small. The overall pooled prevalence of AS and ABPA in adults was 26% (95% CI: 21%, 30%) and 11% (95% CI: 9%, 14%), respectively, with a higher prevalence of ABPA in severe asthma. Conclusion: There is a high burden of AS and ABPA in children with asthma, especially those with severe or poorly controlled asthma. We recommend screening all children with poorly controlled asthma for AS and ABPA (conditional recommendation and moderate certainty of evidence).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.031 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.021 | 0.048 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".