Relation of airway responsiveness to methacholine to parent and child reporting of symptoms suggesting asthma: RESULTS Part 4
In an attempt to define better the relationships between sensitivity and specificity of methacholine responsiveness and parent-reported and child-reported respiratory diagnoses and symptoms, ROC curves were developed by determining the numbers of children with PC20 values below successively lower cut-points reflecting increasing levels of airway responsiveness within each symptom strata. A parental report of physician-diagnosed asthma was significantly associated with airway hyperresponsiveness, in that the area under the ROC curve differed significantly from 0.5 (Figure 1A; P=0.006). The relationship did not achieve significance for wheezing not diagnosed as asthma (P=0.086) but was significant for the combination of physician-diagnosed asthma and recurrent wheezing (Figure 1C; P=0.009). The area under the ROC curve was not significantly different from 0.5 for a parental report of cough or dyspnea alone (P=0.42), but if all positive responses from the parental questionnaire were combined the area under the ROC curve was significantly increased (P=0.037). It’s your turn to benefit from the shopping whenever you need efficient cialis professional 20 mg that will be sure to work for your problem. This is now all very much possible at the best online pharmacy you have ever come across offering it services to you and other international customers interested.
Similarly, when diagnoses and symptoms reported by the children were compared with measurements of responsiveness, there was a highly significant increase in the area under the ROC curve for diagnosed asthma (Figure 1B; P=0.001). The ROC curve for wheezing not diagnosed as asthma was not significant (P=0.276), but all wheezing combined (whether or not diagnosed as asthma — asthma inhalers) was significant (P=0.048). Recurrent cough or dyspnea without wheezing was not significant (P=0.200), but combining all child-reported symptoms gave a significant shift in the ROC curve (P=0.048).
When information from parental and child questionnaires was combined, the areas under the ROC curves for diagnosed asthma, and for asthma and wheezing combined (Figure 1D), were both highly significantly different from 0.5 (P=0.007 and 0.011, respectively), as it was also for any respiratory symptom (P=0.035). However, combining parent and child-reported information did not increase the strength of relationship between wheezing not diagnosed as asthma and airway responsiveness.
Figure 1) Receiver operating characteristic curves for sensitivity (y-axis) and 1-specificity (x-axis) or airway ‘hyperresponsiveness’ at cut-points for provocation concentration of methacholine causing a 20% fall in forced expired volume in 1 s of <1 (far left), <2, <4, <8 and <16 mg/mL and any result (far right) for parental and child resports of diagnoses and symptoms (cumulative hisotry). A Physician-diagnosed asthma (parent-reported) (P=0.006). B Asthma reported by child (P=0.001). C Asthma and/or wheezing (parent-reported) (P=0.009). D Asthma and/or wheezing reported by parent or child (P=0.011)