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


METHODS
Cross-sectional study with a validation substudy.


METHODS
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.


METHODS
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.
Glasgow
N J
NJ
Academic Unit of General Practice and Community Care, Canberra Clinical School, University of Sydney, NSW. Nicholas.Glasgow@calvary-act.com.au
Ponsonby
A L
AL
Yates
R E
RE
McDonald
T
T
Attewell
R
R
D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D020958:Australian Capital Territory / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D011237:Predictive Value of Tests; D015995:Prevalence; D012572:School Health Services; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires