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Effect of asthma intervention on children with undiagnosed asthma
Authors:Joseph Christine L M  Havstad Suzanne  Anderson Elizabeth W  Brown Randall  Johnson Christine Cole  Clark Noreen M
Affiliation:Henry Ford Health System, Department of Biostatistics and Research Epidemiology, Detroit, MI 48202, USA. cjosephl@hfhs.org
Abstract:OBJECTIVE: To measure the effect of an asthma intervention on the functional status and morbidity of children with undiagnosed asthma. STUDY DESIGN: Data from a randomized trial were used to compare outcomes at baseline and follow-up for children with undiagnosed and diagnosed asthma. We studied 510 symptomatic children with diagnosed asthma (diagnosed) and 299 children with symptoms but no diagnosis (undiagnosed). Baseline functioning and morbidity were similar for undiagnosed and diagnosed patients classified as moderate-severe. RESULTS: There were fewer undiagnosed reported allergies, seasonal symptoms, and other respiratory diagnoses (all P < 0.01). Among the moderate-severe, functional status, for example, symptom-days ( P = .02), symptom-nights ( P < .01), and days of restricted activity ( P < .01), was significantly reduced at follow-up for the undiagnosed in the intervention group but not for undiagnosed control subjects. Findings were similar for children with diagnosed asthma. CONCLUSIONS: Children with undiagnosed asthma were generally nonatopic, although some had symptoms at a level comparable to children with a diagnosis. The intervention successfully improved functional status for children with undiagnosed asthma as well as for children with diagnosed asthma. These results can be applied to ongoing discussions related to case detection.
Keywords:BMI, Body mass index   CDC, Centers for Disease Control   ED, Emergency Department   GEE, Generalized estimating equation   NAEPP, National Asthma Education and Prevention Program Expert Panel
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