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——浙大迪迅 译

背景：目前已经开发了许多风险评分来预测儿童哮喘。然而，他们可能无法预测儿童以后的哮喘。本研究的目标是创建儿童风险评分，以预测哮喘的发展和持续到成年的生活。

方法：对怀特岛出生队列(n = 1456)进行前瞻性评估，直至26岁。根据前4年的因素制定哮喘预测评分，使用logistic回归并测试敏感性、特异性和曲线下面积(AUC)，用于预测(i) 18和(ii) 26岁时的哮喘，(iii) 10和18岁时的持续性哮喘(PA)， (iv) 10、18和26岁的哮喘。模型在内部和外部进行了验证。

结果：生成了四个模型来预测每种哮喘的结果。哮喘预测风险评分(ASPIRE)-1: 18岁哮喘的2因素模型(复发性喘息[RW]和4岁皮肤点刺试验阳性[+SPT])(敏感性:0.49，特异性:0.80,AUC: 0.65)。ASPIRE-2: 26岁哮喘的3因素模型(RW、+SPT和母鼻炎)(敏感性:0.60，特异性:0.79,AUC: 0.73)。ASPIRE-3: PA-18的3因素模型(RW， +SPT和4年湿疹)(敏感性:0.63，特异性:0.87,AUC: 0.77)。ASPIRE-4: PA-26的3因素模型(RW, 4年+SPT, 2年复发性胸部感染)(敏感性:0.68，特异性:0.87,AUC: 0.80)。在外部复制ASPIRE-1和ASPIRE-3评分。进一步的评估表明，ASPIRE-1可以代替ASPIRE-2-4，具有相同的预测准确性。

结论：ASPIRE评分可预测持续性哮喘直至年轻人。

原始出处
Allergy
Prediction of adult asthma risk in early childhood using novel adult asthma predictive risk scores
DOI: 10.1111/all.15876
Abstract:
Background:Numerous risk scores have been developed to predict childhood asthma. However, they may not predict asthma beyond childhood. We aim to create childhood risk scores that predict development and persistence of asthma up to young adult life.
Methods:The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed up to 26 years of age. Asthma predictive scores were developed based on factors during the first 4 years, using logistic regression and tested for sensitivity, specificity and area under the curve (AUC) for prediction of asthma at (i) 18 and (ii) 26 years, and persistent asthma (PA) (iii) at 10 and 18 years, and (iv) at 10, 18 and 26 years. Models were internally and externally validated.
Results:Four models were generated for prediction of each asthma outcome. ASthma PredIctive Risk scorE (ASPIRE)-1: a 2-factor model (recurrent wheeze [RW] and positive skin prick test [+SPT] at 4 years) for asthma at 18 years (sensitivity: 0.49, specificity: 0.80, AUC: 0.65). ASPIRE-2: a 3-factor model (RW, +SPT and maternal rhinitis) for asthma at 26 years (sensitivity: 0.60, specificity: 0.79, AUC: 0.73). ASPIRE-3: a 3-factor model (RW, +SPT and eczema at 4 years) for PA-18 (sensitivity: 0.63, specificity: 0.87, AUC: 0.77). ASPIRE-4: a 3-factor model (RW, +SPT at 4 years and recurrent chest infection at 2 years) for PA-26 (sensitivity: 0.68, specificity: 0.87, AUC: 0.80). ASPIRE-1 and ASPIRE-3 scores were replicated externally. Further assessments indicated that ASPIRE-1 can be used in place of ASPIRE-2-4 with same predictive accuracy.
Conclusion:ASPIRE predicts persistent asthma up to young adult life.
First Author:
Abdal J. Farhan
Corresponding author:
Hasan Arshad
Correspondence: S. NIHR Biomedical Research Centre, MP 810, F Level, South Block, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
Email: sha@soton.ac.uk