Overall symptom measurement: which approach?
The syndrome of preschool wheeze includes a wide range of symptomology, measurement of which necessitates assessment of severity as well as prevalence. Most wheezing in this age group is episodic and associated with viral infections, and it is often difficult to distinguish wheeze from other lower respiratory symptoms. An overall measure of symptom severity should include the frequency, duration and magnitude both of episodes and interval symptoms. However, little attention has been paid to either the distinction of acute virus-related episodes from day-to-day symptoms, or their quantification. The type of medication used is sometimes considered as a measure of symptom severity. Since there is no consensus about either the criteria for the use of anti-inflammatory agents or their modulating effect, this practice is unreliable. Without an agreed method to define symptom severity, it is difficult to assess the validity of either population questionnaires or symptom diaries for use in clinical trials. Validation using objective measures is urgently required.
Wilson
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Dept of Paediatrics, Hammersmith Hospital London, UK.
van Bever
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H
D001249:Asthma / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D002675:Child, Preschool; D006801:Humans; D008499:Medical Records; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires