{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:44:04Z","timestamp":1780555444190,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004344","name":"Stichting Astma Bestrijding","doi-asserted-by":"publisher","award":["nr.2010\/011"],"award-info":[{"award-number":["nr.2010\/011"]}],"id":[{"id":"10.13039\/501100004344","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004344","name":"Stichting Astma Bestrijding","doi-asserted-by":"publisher","award":["2018\/012"],"award-info":[{"award-number":["2018\/012"]}],"id":[{"id":"10.13039\/501100004344","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early identification of childhood asthma is critical to prevent over\u2010 and undertreatment. Previous asthma prediction models often rely on subjective outcomes, limiting generalizability. This study aimed to develop an asthma prediction model using objective measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was embedded in a multicenter prospective cohort of children aged 1\u20134\u2009years with recurrent wheezing presenting at pediatric secondary care clinics who were followed up for 12\u2009months and re\u2010assessed between ages 6 and 12\u2009years. Candidate predictors included demographic, environmental, and asthma\u2010related factors. Asthma at school age was defined as at least two of the three criteria: asthma medication use, spirometry with bronchodilator reversibility, and elevated fractional exhaled nitric oxide levels. LASSO regression was applied to identify the most predictive variables in an optimal and parsimonious model, and model performance was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 144 children with recurrent wheezing at age 1\u20134\u2009years, 25% were classified as having asthma at school age. The optimal model for predicting asthma at school age demonstrated good predictive performance (area under the curve (AUC) (95% CI): 0.83 (0.73\u20130.93), sensitivity: 0.69, specificity: 0.86, positive predictive value (PPV): 0.66, and negative predictive value (NPV): 0.88). The parsimonious model showed slightly lower performance (AUC (95% CI): 0.82 (0.71\u20130.94), sensitivity: 0.67, specificity: 0.86, PPV: 0.65, NPV: 0.87).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our models highlight the importance of using objectively defined asthma in early prediction of asthma at school age, as demonstrated by their high discriminative performance. Future studies should validate these models and incorporate clearly defined objective outcome measures when developing new models for pediatric secondary care clinics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70219","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T01:20:36Z","timestamp":1760404836000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early\u2010life prediction of school\u2010age asthma among recurrent Wheezers in preschoolers: The WHEEP study"],"prefix":"10.1111","volume":"36","author":[{"given":"Tarik","family":"Karramass","sequence":"first","affiliation":[{"name":"Generation R Study Group, Erasmus MC University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Department of Pediatrics, Erasmus MC University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrica","family":"Mancino","sequence":"additional","affiliation":[{"name":"Department of Maternal Child Health and Urological Sciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Balemans","sequence":"additional","affiliation":[{"name":"Department of Pediatrics St. Antonius Hospital  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Canisius Wilhelmina Hospital  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"De Groot","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology Zuyderland Hospital  Heerlen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Landstra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Rijnstate Hospital  Arnhem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J. F. M.","family":"Merkus","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine and Allergology, Department of Pediatrics Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia E. M.","family":"Niers","sequence":"additional","affiliation":[{"name":"Department of Pediatrics M\u00e1xima Medical Center  Veldhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Vaessen\u2010Verberne","sequence":"additional","affiliation":[{"name":"Deparment of Pediatrics Amphia Hospital  Breda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"van Klaveren","sequence":"additional","affiliation":[{"name":"Department of Public Health Erasmus MC University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Predictive Analytics and Comparative Effectiveness Center Institute for Clinical Research and Health Policy Studies, Tufts Medical Center  Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"Department of Neonatology Brussels University Hospital  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari\u00ebl","family":"Verwaal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Maasstad Hospital  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari\u00eblle","family":"Pijnenburg","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine and Allergology, Department of Pediatrics Erasmus MC University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6731-9452","authenticated-orcid":false,"given":"Liesbeth","family":"Duijts","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine and Allergology, Department of Pediatrics Erasmus MC University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Division of Neonatology, Department of Neonatal and Pediatric Intensive Care Erasmus MC University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.2009.090348"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30293-X"},{"key":"e_1_2_12_4_1","unstructured":"Global Initiative for Asthma.Global strategy for asthma management and prevention. 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