McMaster researchers in Hamilton making children’s asthma screening less stressful

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Published October 12, 2022 at 12:54 pm

A small child who is being screened for asthma risk may no longer face stressful skin pricks and blood samples, thanks to a screening tool developed by a McMaster University-led research team based in Hamilton.

The new study, whose findings were published in the Journal of the American Medical Association, entailed reviewing data from more than 2,350 children who are partipating in McMaster’s CHILD cohort study (an acronym for Canadian Healthy Infant Longitudinal Development). Data from those children was reviewed using CHART, or CHILDhood Asthma Risk Tool.

The CHART method used information including coughing and wheezing episodes, use of asthma medications and related hospital visits at three years old. It had a 91-per-cent accuracy rate in predicting which children would have persistent wheezing, a key indicator of asthma, by the time they were five years old. Half of the children whom CHART put in the high-risk group for asthma were diagnosed with it two years later, when they turned five.

Of the children whom CHART sorted into the high-risk group at age three, 50 per cent were diagnosed with asthma two years later. The diagnoses were made by clinicians participating in the study.

“We believe the tool is actually even more accurate at predicting asthma than this number suggests,” says Dr. Malcolm Sears, who is CHILD’s founding director, a McMaster professor emeritus of medicine and co-senior author of the study.

“Because of various ambiguities in the way asthma is clinically defined, it is likely that a number of these young kids have asthma that remains formally undiagnosed.”

It will also be a time- and money-saver for family medicine clinics and practitioners.

“The beauty of CHART, the new tool we have developed, is that it can be used by family doctors or nurses in a low-resource primary care setting,” says Co-first author Myrtha E. Reyna-Vargas, a biostatistician at SickKids Hospital in Toronto.

“It can be done on-the-spot and in-the-moment,” Reyna-Vargas adds. “It is cost-free, and it requires no special equipment.”

The findings may come in handy as climate catastrophe-induced triggers of asthma symptoms become more of an everyday phenomena. The Asthma and Allergy Foundation of America includes high heat, high humidity and sudden weather changes among the types of weather that can trigger asthma symptoms.

That might have particular ramifications in Hamilton, which is situated upon traditional territories of the Erie, Neutral, Huron-Wendat, Haudenosaunee and Mississaugas. The Hamilton-Niagara region is the second-most vulnerable area to extreme heat in Canada.

Confirmation that CHART can accurate assess asthma risk might have offshoots beyond reducing stress and needle anxiety when a tiny human is taken to a pediatrician’s office. It may allow for earlier detection, which could reduce hospitalizations of children with asthma.

“Asthma affects nearly 330 million people worldwide, carries a heavy health-care cost and is the leading cause of hospitalization among kids in Canada, especially kids under five,” says CHILD director Dr. Padmaja Subbarao, an adjunct professor in Mac’s department of medicine.

“Earlier detection of this condition will allow doctors to treat kids sooner, so they will suffer less and avoid going to the hospital, thus also lowering costs to the health-care system.”

The CHILD cohort study was launched at McMaster in 2008. It tracks the physical, social and cognitive development of nearly 3,500 Canadian children from before birth.

The threat that climate catastrophe poses to Hamilton residents, the local economy and public infrastructure led to city council declaring a climate emergency in March 2019. The elected leadership of Hamilton also passed a climate action strategy this summer.

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