Asthma screening as part of a routine school health assessment in the Australian Capital Territory

• Published in: Medical journal of Australia 2001-04, Vol.174 (8), p.384-388
• Main Authors: Glasgow, Nicholas J, Ponsonby, Anne‐Louise, Yates, Rachel E, McDonald, Tim, Attewell, Robyn
• Format: Article
• Language: English
• Subjects: Asthma - diagnosis; Asthma - epidemiology; Australia - epidemiology; Australian Capital Territory - epidemiology; Biological and medical sciences; Child; Child, Preschool; Chronic obstructive pulmonary disease, asthma; Cross-Sectional Studies; Female; Humans; Male; Mass Screening; Medical sciences; Pneumology; Predictive Value of Tests; Prevalence; School Health Services; Sensitivity and Specificity; Surveys and Questionnaires
• ISSN: 0025-729X; 1326-5377
• DOI: 10.5694/j.1326-5377.2001.tb143338.x

ABSTRACT Objective To determine the feasibility and performance of a routine screen for childhood asthma in new entrants to primary school relative to diagnosis by a paediatrician. Design Cross‐sectional study with a validation substudy. Participants and setting All 4539 new primary school entrants (mean age, 5.72 years; 95% CI, 5.71–5.74) in the Australian Capital Territory (ACT) in 1999; 180 of these children (73% of the 248 contacted) participated in the validation substudy. Main outcome measure Performance of the screening test relative to a paediatrician's diagnosis of current asthma (defined as a history of wheeze suggestive of a clinical diagnosis of asthma within the past 12 months) based on history and examination. Results 3748 of the 4539 new primary school entrants (83%) returned completed asthma and respiratory questions. The screening test was positive in 38% of children. Estimated sensitivity was 92% (95% CI, 75%–99%); specificity, 76% (95% CI, 72%–80%); positive predictive value, 51% (95% CI, 41%–63%); negative predictive value, 98% (95% CI, 90%–100%); positive likelihood ratio, 3.8 (95% CI, 2.8–4.8); and negative likelihood ratio, 0.14 (95% CI, 0.02–0.33). Conclusions It is feasible to conduct population screens for asthma that have good diagnostic test performance against a specialist paediatrician's diagnosis through school health programs. This approach could facilitate monitoring changes in asthma prevalence over time.