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Pais-Cunha I, Fontoura Matias J, Almeida AL, Magalhães M, Fonseca JA, Azevedo I, Jácome C. Telemonitoring of pediatric asthma in outpatient settings: A systematic review. Pediatr Pulmonol 2024. [PMID: 38742250 DOI: 10.1002/ppul.27046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
Telemonitoring technologies are rapidly evolving, offering a promising solution for remote monitoring and timely management of asthma acute episodes. We aimed to describe current pediatric asthma telemonitoring technologies. A systematic review was conducted until September 2023 on Medline, Scopus, and Web of Science. We included studies of children (0-18 years) with asthma or recurrent wheezing whose respiratory condition was telemonitored outside the healthcare setting. A narrative synthesis was performed. We identified 40 telemonitoring technologies described in 40 studies. The more frequently used technologies for telemonitoring were mobile applications (n = 21) and web-based systems (n = 14). Telemonitoring duration varied between 2 weeks and 32 months. Data collection included asthma symptoms (n = 30), patient-reported outcome measures (PROMs) (n = 11), spirometry/peak flow readings (n = 20), medication adherence (n = 17), inhaler technique (n = 3), air quality (n = 2), and respiratory sounds (n = 2). Both parents and children were the technology target users in most studies (n = 23). Technology training was reported in 23 studies of which 3 provided ongoing support. Automatic feedback was found in 30 studies, mostly related with asthma control. HCP were involved in data management in 27 studies. Technologies were tested in samples from 4 to 327 children, with most studies including school-aged children and/or adolescents (n = 38) and eight including preschool children. This review provides an overview of existing technologies for the outpatient telemonitoring of pediatric asthma. Specific technologies for preschool children represent a gap in the literature that needs to be specifically addressed in future research.
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Affiliation(s)
- Inês Pais-Cunha
- Serviço De Pediatria, Unidade De Gestão Autónoma Da Mulher E Da Criança, Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento De Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal
| | - José Fontoura Matias
- Serviço De Pediatria, Unidade De Gestão Autónoma Da Mulher E Da Criança, Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento De Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Ana Laura Almeida
- Serviço De Pediatria, Unidade De Gestão Autónoma Da Mulher E Da Criança, Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento De Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Manuel Magalhães
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal
- Serviço De Pediatria, Centro Materno Infantil Do Norte, Centro Hospitalar Universitário Do Porto, Porto, Portugal
| | - João A Fonseca
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal
- Allergy Unit, Instituto CUF Porto E Hospital CUF Porto, Porto, Portugal
| | - Inês Azevedo
- Serviço De Pediatria, Unidade De Gestão Autónoma Da Mulher E Da Criança, Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento De Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Cristina Jácome
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal
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Mallet MC, Mozun R, Pedersen ESL, Ardura-Garcia C, Gaillard EA, Latzin P, Moelller A, Kuehni CE. Prevalence of childhood cough in epidemiological studies depends on the question used: findings from two population-based studies. Swiss Med Wkly 2023; 153:40044. [PMID: 36912371 DOI: 10.57187/smw.2023.40044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Epidemiological studies use different questions to assess recurrent cough in children. In two independent population-based studies, we assessed how prevalence estimates of cough vary depending on the questions parents are asked about their child's cough and how answers to the different questions overlap. METHODS We analysed cross-sectional data from two population-based studies on respiratory health: LuftiBus in the School (LUIS), conducted in 2013-2016 among 6- to 17-year-school children in the Canton of Zurich, Switzerland, and the 1998 Leicester Respiratory Cohort (LRC) study, UK where we used data from 6- to 8-year-old children from the 2003 follow-up survey. Both studies used parental questionnaires that included the same three questions on the child's cough, namely cough without a cold, dry cough at night and coughing more than others. We assessed how the prevalence of cough varied depending on the question and how answers to the different questions on cough overlapped. We also assessed how results were influenced by age, sex, presence of wheeze and parental education. RESULTS We included 3457 children aged 6-17 years from LUIS and 2100 children aged 6-8 years from LRC. All respiratory outcomes - cough, wheeze and physician-diagnosed asthma - were reported twice as often in the LRC as in LUIS. We found large differences in the prevalence of parent-reported cough between the three cough questions. In LUIS, 880 (25%) parents reported cough without a cold, 394 (11%) dry night cough, and 159 (5%) reported that their child coughed more than other children. In the LRC, these numbers were 1003 (48%), 527 (25%) and 227 (11%). There was only partial overlap of answers, with 89 (3%) answering yes to all questions in LUIS and 168 (8%) in LRC. Prevalence of all types of cough and overlap between the cough questions was higher in children with current wheeze. CONCLUSION In both population-based studies prevalence estimates of cough depended strongly on the question used to assess cough with only partial overlap of responses to different questions. Epidemiological studies on cough can only be compared if they used exactly the same questions for cough.
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Affiliation(s)
- Maria Christina Mallet
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Switzerland
| | - Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Department of Intensive Care and Neonatology, and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Switzerland
| | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | | | - Erol A Gaillard
- Institute for Lung Health, Department of Respiratory Sciences, College of Life Sciences, Department of Paediatrics, NIHR Biomedical Research Centre: Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Alexander Moelller
- Department of Respiratory Medicine, University Children's Hospital Zurich and Children's Research Centre, University of Zurich, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Urban C, Kiefer A, Conradt R, Kabesch M, Lex C, Zacharasiewicz A, Kerzel S. Validation of the LEOSound® monitor for standardized detection of wheezing and cough in children. Pediatr Pulmonol 2022; 57:551-559. [PMID: 34800333 DOI: 10.1002/ppul.25768] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/29/2021] [Accepted: 11/18/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND A hallmark of many respiratory conditions is the presence of nocturnal symptoms. Nevertheless, especially in children there is currently still a huge diagnostic gap in detecting nighttime symptoms, which leads to an underestimation of the frequency in clinical practise. METHODS We evaluated the clinical applicability and determined the formal test characteristics of the LEOSound ® system, a device for digital long-time recording and automated detection of acoustic airway events. Airway sounds were recorded overnight in 115 children and adolescents (1-17 years) with and without respiratory conditions. The automated classification for "cough" and "wheezing" was subsequently validated against the manual acoustic reassessment by an expert physician. RESULTS The general acceptance was good across all age groups and a technically successful recording was obtained in 98 children, corresponding to 92,976 sound epochs (à 30 s) or a total of 774 h of lung sounds. We found a sensitivity of 89% and a specificity of 99% for the automated detection of cough. For detection of wheezing, sensitivity and specificity were both 98%. The cough index and the wheeze index (events per hour) of individual patients showed a strong positive correlation (cough: rS = 0.85, wheeze: rS = 0.95) and a sufficient agreement of the two assessment methods in the Bland-Altman analysis. CONCLUSION Our data show that the LEOSound® is a suitable device for standardized detection of cough and wheezing and hence a promising diagnostic tool to detect nocturnal respiratory symptoms, especially in children. However, a validation process to reduce false positive classifications is essential in clinical routine use.
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Affiliation(s)
- Christof Urban
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.,Alpenklinik Santa Maria, Bad Hindelang, Germany
| | - Alexander Kiefer
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Regina Conradt
- Division of Pneumology, Department of Internal Medicine, Intensive Care and Sleep Medicine, Philipps-University Marburg, Marburg, Germany
| | - Michael Kabesch
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Christiane Lex
- Department of Pediatric Cardiology and Intensive Care Medicine, University Hospital Goettingen, Goettingen, Germany
| | - Angela Zacharasiewicz
- Department of Pediatrics and Adolescent Medicine, Wilhelminenspital, Teaching Hospital of the University of Vienna, Vienna, Austria
| | - Sebastian Kerzel
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
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Kantar A, Marchant JM, Song WJ, Shields MD, Chatziparasidis G, Zacharasiewicz A, Moeller A, Chang AB. History Taking as a Diagnostic Tool in Children With Chronic Cough. Front Pediatr 2022; 10:850912. [PMID: 35498777 PMCID: PMC9051232 DOI: 10.3389/fped.2022.850912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/21/2022] [Indexed: 11/17/2022] Open
Abstract
Chronic cough is a common symptom of many underlying respiratory and non-respiratory disorders and may be associated with less serious causes, such as gastroesophageal reflux and nasal diseases. Chronic cough in children differs from that in adults with respect to its etiologies and management since it can indicate a symptom of an underlying disease in children. Guidelines for managing chronic cough in children are based on recording the history, followed by physical examination, chest radiography, and spirometry. Thus, taking accurate respiratory history for coughing helps delineate the pathophysiological basis of the cause of chronic cough. Detailed history taking enhances the evaluation and treatment, and facilitates a tailored diagnostic identification of likely diagnoses. While studies have described evidence-based red flags in children with chronic cough, the value of skilled physicians regarding history taking has received less attention for the best patient care. In the present article, we outline the major questions comprising a detailed history taking for chronic cough in children.
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Affiliation(s)
- Ahmad Kantar
- Paediatric Asthma and Cough Centre, Gruppo Ospedaliero San Donato, Bergamo, Italy.,Department of Paediatrics, University Vita Salute San Raffaele, Milano, Italy
| | - Julie M Marchant
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.,Center for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Michael D Shields
- Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom.,Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
| | | | - Angela Zacharasiewicz
- Department of Pediatrics, Adolescent Medicine, Teaching Hospital of the University of Vienna, Wilhelminen Hospital, Klinikum Ottakring, Vienna, Austria
| | - Alexander Moeller
- Division of Respiratory Medicine and Childhood Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Anne B Chang
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.,Center for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia.,Child Health Division, Menzies School of Health Research, Darwin, NT, Australia
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