ORIGINAL ARTICLE

A video questionnaire identifies upper airway abnormalities in preschool children with reported wheeze

S Saglani¹, S A McKenzie², A Bush¹, D N R Payne¹

¹ Paediatric Respiratory Medicine, Airways Diseases Section of the National Heart and Lung Institute, Imperial College, London, UK
² Department of Paediatrics, The Royal London Hospital, London, UK

Correspondence to:
Dr D Payne
Senior Lecturer in Paediatric Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; d.payne{at}imperial.ac.uk

Background: Accurate characterisation of subjects is essential to interpret data from studies investigating preschool wheezing.

Aim: To assess whether a video questionnaire (VQ) identifies upper airway abnormalities in preschool children with reported wheeze.

Methods: Forty three children (median age 17 months, range 3–58) undergoing fibreoptic bronchoscopy for clinical investigation of troublesome noisy breathing at a tertiary centre were studied. Parents were shown a VQ with four clips (wheeze, stridor, and two other upper respiratory noises) and chose the clip(s) resembling their child’s main symptom. Doctor observed symptoms, parental reported symptoms, and symptoms identified on VQ were related to bronchoscopy.

Results: Thirty subjects had wheeze as the main symptom: 19 had doctor observed wheeze (DOW) and 11 had parental reported wheeze (RW). Parents of two of the subjects with RW identified wheeze alone on VQ and both had normal bronchoscopic findings. Five of the remaining nine subjects with RW had upper airway abnormalities at bronchoscopy. Parents of six subjects with RW identified a noise other than wheeze on VQ; four of these had upper airway abnormalities. Parents of two subjects with RW did not identify a noise on VQ; one had upper airway abnormalities. Of the 19 with DOW, nine parents identified wheeze alone on VQ, and all had a normal upper airway. Parents of nine subjects with DOW identified a noise other than wheeze as an equal or only symptom, (no noise identified in one), and five had upper airway abnormalities.

Conclusion: A VQ helps to identify upper airway abnormalities in preschool children with a history of wheezing.

Abbreviations: DOS, doctor observed stridor; DOW, doctor observed wheeze; FOB, fibreoptic bronchoscopy; RS, reported stridor; RW, parental reported wheeze; URN, upper respiratory noise; VQ, video questionnaire

Keywords: wheeze; preschool; video questionnaire; bronchoscopy; upper airway

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