Parental understanding of "wheeze" and its impact on asthma prevalence estimates

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
³ Swiss Paediatric Respiratory Research Group, Dept. of Social and Preventive Medicine, University of Bern, CH - 3012 Bern, Switzerland; and 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.

	Abstract

The epidemiology of wheeze in children, assessed by questionnaires, is dependent on parents' understanding of the term "wheeze".

In a questionnaire survey of a random population sample of 4236 children aged 6-10 years we assessed parents' definition of wheeze, determined predictors of a correct definition and assessed the potential impact of incorrect answers on prevalence estimates from the survey.

Current wheeze was reported by 13.2% of children. Overall 83.5% of parents correctly identified "whistling or squeaking" as the definition of wheeze, the proportion being higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio 3.0), maternal history of asthma (1.5) and maternal education (1.5) were significantly associated with a correct answer, while the converse was found for south Asian ethnicity (0.6), first language not English (0.6) and living in a deprived neighbourhood (0.6).

We showed that misunderstanding could lead to important bias in assessing the prevalence of wheeze, leading to an underestimate in children from south Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term "wheeze".

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