title: Asthma screening as part of a routine school health assessment in the Australian Capital Territory.
abstract: 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.
authors.affiliation: Academic Unit of General Practice and Community Care, Canberra Clinical School, University of Sydney, NSW. Nicholas.Glasgow@calvary-act.com.au
authors.forename: N J
authors.initials: NJ
authors.lastname: Glasgow
authors.forename: A L
authors.initials: AL
authors.lastname: Ponsonby
authors.forename: R E
authors.initials: RE
authors.lastname: Yates
authors.forename: T
authors.initials: T
authors.lastname: McDonald
authors.forename: R
authors.initials: R
authors.lastname: Attewell
mesh_terms: 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