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Eur Respir J 2008, doi:10.1183/09031936.00153507
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ORIGINAL ARTICLE |
Distinguishing phenotypes of childhood wheeze and cough using latent class analysis
1 Swiss paediatric Respiratory Research Group, Dept of Social and Preventive Medicine, University of Bern, CH - 3012 Bern, Switzerland
2 The Leicester Children's Asthma Centre, Division of Child Health, Dept of Infection, Immunity & Inflammation, University of Leicester, Leicester, LE2 7LX, UK
* To whom correspondence should be addressed. E-mail: kuehni{at}ispm.unibe.ch.
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Abstract |
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Airway disease in childhood comprises a heterogeneous group of disorders. Attempts to distinguish different phenotypes have generally considered few disease dimensions. This study examines phenotypes of childhood wheeze and chronic cough, by fitting a statistical model to data representing multiple disease dimensions.
From a population-based, longitudinal cohort study of 1650 preschool children, 319 with parent-reported wheeze or chronic cough were included. Phenotypes were identified by latent class analysis using data on symptoms, skin-prick tests, lung function and airway responsiveness from two preschool surveys. These phenotypes were then compared with respect to outcome at school age.
The model distinguished three phenotypes of wheeze and two phenotypes of chronic cough. Subsequent wheeze, chronic cough and inhaler use at school age differed clearly between the five phenotypes. The wheeze phenotypes shared features with previously described entities and partly reconciled discrepancies between existing sets of phenotype labels.
This novel multidimensional approach has the potential to identify clinically relevant phenotypes not only in paediatric disorders but also in adult obstructive airway diseases, where phenotype definition is an equally important issue.
Keywords: Airway function, allergy, bronchial responsiveness, cluster analysis, latent class modelling, wheeze/asthma
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