{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T02:28:38Z","timestamp":1793672918059,"version":"4.5.1"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003554","name":"Lundbeck Foundation","doi-asserted-by":"publisher","award":["R16\u2010A1694"],"award-info":[{"award-number":["R16\u2010A1694"]}],"id":[{"id":"10.13039\/501100003554","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":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Asthma and allergic rhinitis (AR) follow heterogeneous childhood trajectories, and reliable early prediction of persistence or remission remains challenging. We investigated whether machine learning models applied to early\u2010life data could predict long\u2010term asthma and AR outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed data from 411 children in the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC\n                      <jats:sub>2000<\/jats:sub>\n                      ) cohort using 113 early\u2010life clinical, genetic, environmental, immunological, and lung function features. Five machine learning models were trained to predict four outcomes: persistent asthma versus controls, persistent asthma versus asthma in remission, persistent AR versus controls, and teen\u2010onset AR versus controls. Model interpretability was assessed using SHapley Additive exPlanations (SHAP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Predictive performance was limited across all outcomes, and no model achieved an AUROC above 0.65. The highest performance was observed for persistent AR versus controls, where the tree\u2010based models performed similarly, with AUROCs around 0.63. For persistent asthma versus controls, Random Forest and XGBoost both achieved an AUROC of 0.59. Performance was weak for distinguishing persistent asthma from asthma in remission and for predicting teen\u2010onset AR, with the best models reaching AUROCs of 0.60 and 0.59, respectively. SHAP analyses of the best\u2010performing models identified biologically plausible features, including aeroallergen sensitization and genetic predisposition for persistent asthma, and familial, immunological, and growth\u2010related features for persistent AR, but these signals did not translate into strong discriminative performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this deeply phenotyped high\u2010risk birth cohort, early\u2010life data analyzed using machine learning did not reliably predict long\u2010term asthma or AR outcomes. These findings suggest that early\u2010life data alone may be insufficient for individual prognostic stratification and that repeated measurements later in childhood may be needed to improve prediction.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/pai70498-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70498","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:51:33Z","timestamp":1791546693000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early predictors of persistent childhood asthma and allergic rhinitis: A machine learning study using post\u2010hoc explainability"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5006-0911","authenticated-orcid":false,"given":"Frederikke Rosenvinge","family":"Skov","sequence":"first","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital\u2013Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Pediatrics Copenhagen University Hospital\u2013N\u00e6stved, Slagelse and Ringsted  Slagelse Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3541-9624","authenticated-orcid":false,"given":"Mario","family":"Lovri\u0107","sequence":"additional","affiliation":[{"name":"Centre for Bioanthropology, Institute for Anthropological Research  Zagreb Croatia"},{"name":"Department of Food Science University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6049-1683","authenticated-orcid":false,"given":"Tamo","family":"Sultan","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital\u2013Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Pediatrics Copenhagen University Hospital\u2013N\u00e6stved, Slagelse and Ringsted  Slagelse Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2003-1018","authenticated-orcid":false,"given":"Klaus","family":"B\u00f8nnelykke","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital\u2013Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Chawes","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital\u2013Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4989-9769","authenticated-orcid":false,"given":"Jakob","family":"Stokholm","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital\u2013Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Pediatrics Copenhagen University Hospital\u2013N\u00e6stved, Slagelse and Ringsted  Slagelse Denmark"},{"name":"Department of Food Science University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-0461","authenticated-orcid":false,"given":"Jonathan","family":"Thorsen","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital\u2013Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten Arendt","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital\u2013Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Food Science University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5827-0885","authenticated-orcid":false,"given":"Ann\u2010Marie Malby","family":"Schoos","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital\u2013Herlev and Gentofte  Copenhagen Denmark"},{"name":"Department of Pediatrics Copenhagen University Hospital\u2013N\u00e6stved, Slagelse and Ringsted  Slagelse Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Pediatrics Copenhagen University Hospital\u2013Amager and Hvidovre  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01620.x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13108"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.11.020"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02395-2021"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23795"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.02.024"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.14862"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.13109"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.01.041"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.10.014"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201101-0111OC"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-215025"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-200324"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61398-1"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2024-002634"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.04173-2020"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-078378"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/metabo14030136"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/children8050376"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1010933404324"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9868.2005.00503.x"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10822-020-00314-0"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177678"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1145\/2939672.2939785"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.04.005"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(22)00188-1"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/cem.3349"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(21)00208-9"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-081554"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02288-2021"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2024.100994"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.70032"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11121808"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-24080-x"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"}],"container-title":["Pediatric Allergy and Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pai.70498","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pai.70498","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pai.70498","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T02:23:48Z","timestamp":1793672628000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pai.70498"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":35,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/pai.70498"],"URL":"https:\/\/doi.org\/10.1111\/pai.70498","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/PAI.70498\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/PAI.70498\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/PAI.70498\/v1\/decision1","asserted-by":"object"}]},"ISSN":["0905-6157","1399-3038"],"issn-type":[{"value":"0905-6157","type":"print"},{"value":"1399-3038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2025-12-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70498"}}