Validation of a rhinitis symptom questionnaire (ISAAC core questions) in a population of Swiss school children visiting the school health services. SCARPOL-team. Swiss Study on Childhood Allergy and Respiratory Symptom With Respect to Air Pollution and Climate. International Study of Asthma and Allergies in Childhood

Institute of Social and Preventive Medicine, University of Basel, Switzerland.
Pediatric Allergy and Immunology (Impact Factor: 3.4). 06/1997; 8(2):75-82.
Source: PubMed


The primary aim of the study was to assess the validity of the ISAAC core questions on rhinitis in a population of Swiss school children by comparing them to skin prick test results. Second, the positive predictive value in detecting atopy among children with rhinitis symptoms was determined. Third, agreement between parental reports of hay fever and rhinitis symptoms was evaluated, since earlier Swiss prevalence surveys had exclusively relied on reported hay fever.
Two thousand nine hundred and fifty-four (81.2%) parents of 7, 10 and 14-year old children filled in an exhaustive questionnaire which included the ISAAC core questions on rhinitis. Two thousand one hundred and twenty children also underwent skin prick testing against six common aeroallergens (grass mixture, birch, mugwort, D. pteronyssinus, cat and dog dander). The analysis is restricted to children with both questionnaire data and skin prick test results.
Sensitization to any allergen was most strongly associated with reported hay fever (OR = 5.7, 95% CI 4.4-7.4), nose problems accompanied by itchy-watery eyes (OR = 4.4, 95% CI: 3.3-5.7), symptoms occurring only during pollen season (March through September) (OR = 4.9, 95% CI: 3.6-6.5) and a combination of these latter two symptoms (OR = 5.8, 95% CI: 4.1-8.1). The association was stronger for a sensitization to outdoor allergens than for indoor allergens. The specificity of the various questions was high, ranging from 77.5% to 97.6%, but the sensitivity was low (2.6% to 42.7%). The positive predictive value for atopy among children with symptoms was 63% for sneezing accompanied by itchy-watery eyes, 67% for symptoms occurring only during the pollen season and 70% for reported hay fever. However, agreement between reported rhinitis symptoms and hay fever was only moderate. About one third of the children with symptoms indicative of seasonal rhinitis did not report the label "hay fever".
We conclude from our analyses that the ISAAC core questions on rhinitis are highly specific and therefore useful in excluding atopy. In addition they have a high positive predictive value in detecting atopy among children with symptoms, but they are not helpful for detecting atopy in a general population of children (low sensitivity). To monitor time trends in the prevalence of allergic rhinitis in Switzerland, questions on rhinitis symptoms as well as on the diagnostic label "hay fever" have to be included in a questionnaire because they contain complementary information since under-diagnosis of allergic rhinitis is common.

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Available from: Brunello Wüthrich, May 24, 2014
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    • "Allergic rhinitis was diagnosed in children with seasonal symptoms and sensitization to relevant allergens measured by a specific IgE test [14]. Symptoms were defined as persistent troublesome sneezing or blocked or runny nose severely affecting the well-being of the child in periods without common cold, fever or flu [15]. "
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    ABSTRACT: Background The longitudinal birth cohort study is the preferred design for studies of childhood health, particularly atopic disease. Still, prospective data collection depends on recollection of the medical history since the previous visit representing a potential recall-bias. We aimed to ascertain the quality of information on atopic disease and other health symptoms reported by parental interview in a closely monitored birth cohort study. Possible bias from symptom severity and socioeconomics were sought. Methods Copenhagen study on Asthma in Childhood (COPSAC) is a clinical birth cohort study of 411 children born of asthmatic mothers from 1999 to 2001. Child health is monitored at six-monthly visits with particular emphasis on atopic symptoms and infections. Data from the first three study years on 260 children was compared with records from their family practitioner as an external reference. Results A total of 6134 medical events were reported at the COPSAC interviews. Additional 586 medical events were recorded by family practitioners but not reported at the interview. There were no missed events related to asthma, eczema or allergy. Respiratory, infectious and skin related symptoms showed completeness above 90%, other diseases showed lower completeness around 77%. There was no meaningful influence from concurrent asthma or socioeconomics. Conclusions The COPSAC study exhibited full sensitivity to the main study objectives, atopic disease, and high sensitivity to respiratory, infectious and skin related illness. Our findings support the validity of parental interviews in longitudinal cohort studies investigating atopic disease and illness in childhood.
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    • "On the other hand, the reported specificity of the core questionnaire during validation in the SCARPOL study was high (77.5% to 97.6%), which makes it useful for ruling out but not helpful in detecting atopy since the sensitivity is low (2.6% to 42.7%). This may lead to an underestimation of the prevalence [12]. "
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    ABSTRACT: There has been no documented data on the prevalence of allergic rhinitis among Filipino adults. The objective of this study is to determine the prevalence of allergic rhinitis among adults in the Philippines. Using a multi-staged cluster sampling methodology, this study evaluated 7,202 adults from 3,744 households, 79 provinces and 17 regions. A pre-validated written questionnaire for allergic rhinitis based on the International Study of Asthma and Allergies of Childhood was used as the survey instrument. The response rate obtained from the interview was 94.1%. The overall prevalence of nose symptoms in the past 12 months was 20% while prevalence of nose symptoms at any time in the past was 23.8%. The proportion among both sexes was similar. The prevalence was highest among the respondents 40-49 years old. The overall prevalence of nose and eye symptoms for the past twelve months was 14.0%. The prevalence of respondents who reported presence of nose problems for the past twelve months was similar across the 12 months of the year with highest rates noted in the months of June and May. Respondents from the rural area (22.1%) reported a higher prevalence of nose symptoms for the past twelve months compared to respondents from urban area (18%). There was no significant difference in prevalence of nose symptoms among residents living in coastal and/or inland areas. The overall prevalence of allergic rhinitis in the Philippines based on the 2008 National Nutrition and Health Survey is 20.0%.
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    • "Much of our understanding of the epidemiology of rhinitis derives from studies of self-reported disease. In order to distinguish between infective and non-infective rhinitis, the present study used the ISAAC questionnaire, of which as been evaluated (20), asking whether a subject has had a problem with sneezing, or a runny or validity blocked nose in the absence of a cold or the flu. The present study showed that the prevalence of all forms of non-infectious rhinitis ranged from 15% to 25%, a result similar to that produced by a study on 5,349 adults aged 16-65 yr in south London (21). "
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    ABSTRACT: It has been demonstrated that spider mites such as the two-spotted spider mite (Tetranychus urticae) are important allergens for fruit farmers. A total of 2,467 adults (795 metropolitan urban, 788 non-metropolitan urban, and 884 rural subjects) were enrolled. They responded to the questionnaire, and underwent methacholine bronchial provocation tests as well as skin prick tests to locally common aeroallergens including the two-spotted spider mite. The prevalences of asthma and rhinitis as reported on the questionnaire were 7.8% and 16.4% of adults aged 20-35, 9.4% and 24.7% of those 36-50, and 17.7% and 21.7% of those older than 50, respectively. Among the older group, the two-spotted spider mite was the most common sensitizing allergen, although it was second of that of house dust mites among the other two age groups. Sensitization to the two-spotted spider mite was significantly associated with the prevalence of asthma and rhinitis among the younger age group, and associated with the prevalence of rhinitis among the older age group. The two-spotted spider mite might be a common sensitizing allergen in the general population of adults, and sensitization to this mite may play a role in the manifestation of asthma and rhinitis symptoms during adulthood.
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