Asthma and lower airway diseaseAn exploration of factors underlying asthma care and morbidity: A factor analysis of clinical variables
Section snippets
Study population
The study population consists of a prospective cohort of 197 children (age 2-17 years) who presented to 1 of 3 EDs for the evaluation and treatment of an acute asthma exacerbation in western Michigan. The 3 hospitals were chosen to represent an urban, suburban, and rural location to ensure breadth of sampling. Children were eligible if they presented with signs and symptoms compatible with an acute asthma exacerbation (shortness of breath, coughing, wheezing, or chest tightness), and had a
Results
A total of 197 subjects were enrolled over a 1-year period, and follow-up information was available for 166 (84%). Five subjects were excluded from the factor analysis because of missing data, leaving 161 subjects for factor correlations. Demographic information of the subjects is displayed in Table I. The majority of the subjects was seen at the urban hospital and was more likely to be white and male. The specific observed variables, including risk definitions and distribution, are displayed
Discussion
The current study identified 4 factors that explain most of the variance observed in common clinical variables in the management and follow-up of a cohort of children with asthma. The current factor analysis differs from risk stratification tools or risk assessment models in that we are attempting to identify the latent variables (underlying constructs) that are reflected by commonly used observed variables, describe how these factors interrelate, and observe their association with morbidity as
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Asthma control in children, socioeconomic inequality and health care
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2009, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :Indeed, children with persistent asthma with previous exacerbations are more likely to have a repeat exacerbation despite controller treatment.29 Miller et al30 also revealed that previous severe disease was an important risk factor to identify patients at risk for future asthma morbidity in children. In our study, most patients with incidents of acute asthma exacerbation had persistent AHR, poor lung function during treatment, a history of smoking, and a long duration of asthma.
Follow-up Care for Children With Asthma After Emergency Department Visits
2009, Clinical Pediatric Emergency MedicineCitation Excerpt :Focus groups suggest that beliefs and misconceptions about asthma are among the most important barriers to establishing ongoing care [37]. Miller et al [38] evaluated risk factors for future asthma morbidity in a cohort of children and found that previous severe disease was the only factor that predicted 6-month morbidity. For many children, an ED visit represents either severe disease or the perception of severe disease for the parents [31,39,40].
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2009, Journal of Allergy and Clinical ImmunologyCitation Excerpt :Although the rate of asthma-related ED use by white individuals decreased between 1998 and 2005, since 2000 it has actually increased for black patients. Miller et al54 used factor analysis, a statistical method of summarizing relationships among a large set of variables,55 to explore factors determining future asthma morbidity in children who had an ED visit for asthma. Although the analysis used a cohort of children, it may be applicable in adults.
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Disclosure of potential conflict of interest: F. L. Oswald has received research support from Navy Personnel Research Studies and the College Board. The rest of the authors have declared that they have no conflict of interest.