Association of delayed asthma diagnosis with asthma exacerbations in children
Background: There is a significant delay between symptom onset and diagnosis of childhood asthma, but the impact of this delay on asthma outcomes has not been well understood. Objectives: We sought to study the association of delayed diagnosis of asthma with asthma exacerbations (AEs) in children. M...
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Elsevier
2025-05-01
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| Series: | Journal of Allergy and Clinical Immunology: Global |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772829325000104 |
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| author | Chung-Il Wi, MD Euijung Ryu, PhD Katherine S. King, MS Jung Hyun Kwon, MD, PhD Joshua T. Bublitz, BS Miguel Park, MD Sergio E. Chiarella, MD Jason D. Greenwood, MD, MS Thanai Pongdee, MD Lynnea Myers, PhD Björn Nordlund, PhD Sunghwan Sohn, PhD Elham Sagheb, MS Bhavani Singh Agnikula Kshatriya, MS Dave Watson, PhD Hongfang Liu, PhD Beverley J. Sheares, MD, MS Carla M. Davis, MD Wade Schulz, MD, PhD Young J. Juhn, MD, MPH |
| author_facet | Chung-Il Wi, MD Euijung Ryu, PhD Katherine S. King, MS Jung Hyun Kwon, MD, PhD Joshua T. Bublitz, BS Miguel Park, MD Sergio E. Chiarella, MD Jason D. Greenwood, MD, MS Thanai Pongdee, MD Lynnea Myers, PhD Björn Nordlund, PhD Sunghwan Sohn, PhD Elham Sagheb, MS Bhavani Singh Agnikula Kshatriya, MS Dave Watson, PhD Hongfang Liu, PhD Beverley J. Sheares, MD, MS Carla M. Davis, MD Wade Schulz, MD, PhD Young J. Juhn, MD, MPH |
| author_sort | Chung-Il Wi, MD |
| collection | DOAJ |
| description | Background: There is a significant delay between symptom onset and diagnosis of childhood asthma, but the impact of this delay on asthma outcomes has not been well understood. Objectives: We sought to study the association of delayed diagnosis of asthma with asthma exacerbations (AEs) in children. Methods: Using the Mayo Clinic birth cohort, we identified children with a diagnosis of asthma from electronic health records. We defined onset date as the date when subjects first met predetermined asthma criteria ascertained by an electronic health records–based natural language processing algorithm. Delay in diagnosis (DD) was defined as first diagnosis >30 days from onset date (vs timely diagnosis [TD] within 30 days). The primary outcome was AE after the index date (for DD: first diagnosis date vs for TD: clinic visit at similar delay from diagnosis as matched DD counterpart). A Cox proportional hazard model was used to test the association between delayed diagnosis status and risk of AE, adjusting for sociodemographics, care quality, and asthma severity. Results: Among 537 matched pairs of DD and TD (median age at index date: 4.1 years), a total of 344 and 253 children in DD and TD, respectively, had ≥1 AE during median follow-up period of 9.3 years. Children in the DD group had a significantly increased risk of AE compared to TD (adjusted hazard ratio: 1.53; 95% CI: 1.28, 1.80; P < .001). Conclusions: DD of asthma in children is associated with an increased risk of AE compared to TD. TD of asthma should be an important priority in childhood asthma management. |
| format | Article |
| id | doaj-art-7817caf29e1f461ab69fd022a8187e25 |
| institution | Kabale University |
| issn | 2772-8293 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
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| series | Journal of Allergy and Clinical Immunology: Global |
| spelling | doaj-art-7817caf29e1f461ab69fd022a8187e252025-02-08T05:01:44ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-05-0142100409Association of delayed asthma diagnosis with asthma exacerbations in childrenChung-Il Wi, MD0Euijung Ryu, PhD1Katherine S. King, MS2Jung Hyun Kwon, MD, PhD3Joshua T. Bublitz, BS4Miguel Park, MD5Sergio E. Chiarella, MD6Jason D. Greenwood, MD, MS7Thanai Pongdee, MD8Lynnea Myers, PhD9Björn Nordlund, PhD10Sunghwan Sohn, PhD11Elham Sagheb, MS12Bhavani Singh Agnikula Kshatriya, MS13Dave Watson, PhD14Hongfang Liu, PhD15Beverley J. Sheares, MD, MS16Carla M. Davis, MD17Wade Schulz, MD, PhD18Young J. Juhn, MD, MPH19Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn; Precision Population Science Lab, Mayo Clinic, Rochester, MinnPrecision Population Science Lab, Mayo Clinic, Rochester, Minn; Division of Computational Biology, Mayo Clinic, Rochester, MinnPrecision Population Science Lab, Mayo Clinic, Rochester, Minn; Division of Clinical Trial and Biostatistics, Mayo Clinic, Rochester, MinnPrecision Population Science Lab, Mayo Clinic, Rochester, Minn; Department of Pediatrics, Korea University College of Medicine, Seoul, South KoreaDivision of Clinical Trial and Biostatistics, Mayo Clinic, Rochester, MinnDivision of Allergic Diseases, Mayo Clinic, Rochester, MinnDivision of Allergic Diseases, Mayo Clinic, Rochester, MinnDepartment of Family Medicine, Mayo Clinic, Rochester, MinnDivision of Allergic Diseases, Mayo Clinic, Rochester, MinnPrecision Population Science Lab, Mayo Clinic, Rochester, Minn; Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; Lung-Allergy Department, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, SwedenWomen’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; Lung-Allergy Department, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, SwedenDepartment of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MinnDepartment of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MinnCenter for Digital Health, Mayo Clinic, Rochester, MinnPrecision Population Science Lab, Mayo Clinic, Rochester, Minn; Division of Clinical Trial and Biostatistics, Mayo Clinic, Rochester, MinnDepartment of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MinnSection of Pulmonary, Allergy/Immunology, and Sleep Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, ConnDivision of Immunology, Allergy, and Retrovirology, Baylor College of Medicine, Houston, TexInformatics Section, Department of Informatics Laboratory Medicine, Yale School of Medicine, New Haven, ConnDepartment of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn; Department of Internal Medicine, Mayo Clinic, Rochester, Minn; Precision Population Science Lab, Mayo Clinic, Rochester, Minn; Corresponding author: Young J. Juhn, MD, MPH, Professor of Pediatrics, Director, Precision Population Science Lab, Department of Pediatric and Adolescent Medicine/Internal Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905.Background: There is a significant delay between symptom onset and diagnosis of childhood asthma, but the impact of this delay on asthma outcomes has not been well understood. Objectives: We sought to study the association of delayed diagnosis of asthma with asthma exacerbations (AEs) in children. Methods: Using the Mayo Clinic birth cohort, we identified children with a diagnosis of asthma from electronic health records. We defined onset date as the date when subjects first met predetermined asthma criteria ascertained by an electronic health records–based natural language processing algorithm. Delay in diagnosis (DD) was defined as first diagnosis >30 days from onset date (vs timely diagnosis [TD] within 30 days). The primary outcome was AE after the index date (for DD: first diagnosis date vs for TD: clinic visit at similar delay from diagnosis as matched DD counterpart). A Cox proportional hazard model was used to test the association between delayed diagnosis status and risk of AE, adjusting for sociodemographics, care quality, and asthma severity. Results: Among 537 matched pairs of DD and TD (median age at index date: 4.1 years), a total of 344 and 253 children in DD and TD, respectively, had ≥1 AE during median follow-up period of 9.3 years. Children in the DD group had a significantly increased risk of AE compared to TD (adjusted hazard ratio: 1.53; 95% CI: 1.28, 1.80; P < .001). Conclusions: DD of asthma in children is associated with an increased risk of AE compared to TD. TD of asthma should be an important priority in childhood asthma management.http://www.sciencedirect.com/science/article/pii/S2772829325000104Diagnosis delayasthmaoutcomesexacerbationcare qualitydigital phenotyping |
| spellingShingle | Chung-Il Wi, MD Euijung Ryu, PhD Katherine S. King, MS Jung Hyun Kwon, MD, PhD Joshua T. Bublitz, BS Miguel Park, MD Sergio E. Chiarella, MD Jason D. Greenwood, MD, MS Thanai Pongdee, MD Lynnea Myers, PhD Björn Nordlund, PhD Sunghwan Sohn, PhD Elham Sagheb, MS Bhavani Singh Agnikula Kshatriya, MS Dave Watson, PhD Hongfang Liu, PhD Beverley J. Sheares, MD, MS Carla M. Davis, MD Wade Schulz, MD, PhD Young J. Juhn, MD, MPH Association of delayed asthma diagnosis with asthma exacerbations in children Journal of Allergy and Clinical Immunology: Global Diagnosis delay asthma outcomes exacerbation care quality digital phenotyping |
| title | Association of delayed asthma diagnosis with asthma exacerbations in children |
| title_full | Association of delayed asthma diagnosis with asthma exacerbations in children |
| title_fullStr | Association of delayed asthma diagnosis with asthma exacerbations in children |
| title_full_unstemmed | Association of delayed asthma diagnosis with asthma exacerbations in children |
| title_short | Association of delayed asthma diagnosis with asthma exacerbations in children |
| title_sort | association of delayed asthma diagnosis with asthma exacerbations in children |
| topic | Diagnosis delay asthma outcomes exacerbation care quality digital phenotyping |
| url | http://www.sciencedirect.com/science/article/pii/S2772829325000104 |
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