A video questionnaire identifies upper airway abnormalities in pre-school children with reported wheeze

Sejal Saglani ¹, Sheila A McKenzie ², Andrew Bush ¹ and Donald N Payne ^1*

¹ Imperial College at The Royal Brompton Hospital, United Kingdom
² The Royal London Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: d.payne{at}imperial.ac.uk.

Accepted 21 March 2005

Abstract

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

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

Methods:We studied 43 children (median age 17 [range 3-58] months) undergoing fibreoptic bronchoscopy for clinical investigation of troublesome noisy breathing at a tertiary centre. 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:30/43 subjects had wheeze as the main symptom. 19/30 had doctor-observed wheeze (DOW) and 11/30 had parental-reported wheeze (RW). Parents of 2/11 subjects with RW identified wheeze alone on VQ and both had normal bronchoscopic findings. 5 of the remaining 9 subjects with RW had upper airway abnormalities at bronchoscopy. Parents of 6 subjects with RW identified a noise other than wheeze on VQ and 4/6 had upper airway abnormalities. Parents of 2 subjects with RW did not identify a noise on VQ; one had upper airway abnormalities. Of the 19 with DOW, 9/19 parents identified wheeze alone on VQ, and all had a normal upper airway. Parents of 9/19 subjects with DOW identified a noise other than wheeze as an equal or only symptom, (no noise identified in 1/19) and 5/9 had upper airway abnormalities. Conclusion: A VQ helps to identify upper airway abnormalities in pre-school children with a history of wheezing.

Keywords: bronchoscopy, pre-school, upper airway, video questionnaire, wheeze

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