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Pedersen, ESL; Glick, S; Jong, CCMD; Ardura-Garcia, C; Jochmann, A; Casaulta, C; Hartog, K; Marangu-Boore, D; Mueller-Suter, D; Regamey, N; Singer, F; Moeller, A; Kuehni, CE.
Reporting of paediatric exercise-induced respiratory symptoms by physicians and parents: an observational prospective study
SWISS MED WKLY. 2025; 155(4): 3939 Doi: 10.57187/s.3939
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Co-Autor*innen der Med Uni Graz
Singer Florian
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Abstract:
STUDY AIMS: Routinely collected health data are increasingly used for research; however important anamnestic details may be missing from medical records. We compared physician documentation of paediatric exercise-induced respiratory symptoms in clinical notes with parental questionnaire responses for the same children. METHODS: We analysed data from the Swiss Paediatric Airway Cohort (SPAC), a multicentre observational study of children treated in Swiss outpatient pulmonology clinics. We included children aged 6 to 17 years who were referred to a paediatric pulmonologist for evaluation of exercise-induced respiratory symptoms. Features of exercise-induced respiratory symptoms recorded by physicians were extracted from outpatient clinic letters transmitted to the referring physician, while parent-reported exercise-induced respiratory symptom data was collected from a standardised questionnaire completed at Swiss Paediatric Airway Cohort enrolment. We calculated agreement between physician-documented and parent-reported exercise-induced respiratory symptom characteristics using Cohen's and Fleiss's kappa. RESULTS: Of 1669 children participating in the Swiss Paediatric Airway Cohort (2017-2019), 193 (12%) met the inclusion criteria, of whom 48% were girls. Physicians provided detailed information on exercise-induced respiratory symptoms in 186 (96%) outpatient clinic letters. Documented characteristics included: type of physical activity triggering exercise-induced respiratory symptoms (69%), location of exercise-induced respiratory symptoms in chest or throat (48%), respiratory phase of exercise-induced respiratory symptoms (45%) and timing of exercise-induced respiratory symptoms during or after exercise (37%). Previous bronchodilator use (94%) and its effect on exercise-induced respiratory symptoms (88%) were consistently documented by physicians. The clinic letters for children diagnosed with dysfunctional breathing more often contained detailed exercise-induced respiratory symptom characteristics than those diagnosed with asthma. The level of agreement between physician-documented and parent-reported exercise-induced respiratory symptoms was moderate for use of bronchodilators (κ = 0.53) and poor-to-fair for all other features (κ = 0.01-0.36). CONCLUSION: This study highlights that outpatient clinic letters may lack some details on exercise-induced respiratory symptom characteristics - information that parents could provide. A standardised and detailed method for documenting paediatric respiratory symptoms in the coordinated data infrastructure may enhance future analyses of routinely collected health data.
Find related publications in this database (using NLM MeSH Indexing)
Humans - administration & dosage
Child - administration & dosage
Female - administration & dosage
Male - administration & dosage
Prospective Studies - administration & dosage
Parents - administration & dosage
Adolescent - administration & dosage
Switzerland - administration & dosage
Surveys and Questionnaires - administration & dosage
Exercise - physiology
Physicians - statistics & numerical data
Asthma, Exercise-Induced - diagnosis

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