Prediction of Childhood Asthma Using Conditional Probability and Discrete Event Simulation
DOI:
https://doi.org/10.6000/1929-6029.2013.02.03.2Keywords:
Children, Asthma, Model, Discrete event, Probability, TobaccoAbstract
Asthma prevalence in children and adolescents in Spain is 10-17%. It is the most common chronic illness during childhood. Prevalence has been increasing over the last 40 years and there is considerable evidence that, among other factors, continued exposure to cigarette smoke results in asthma in children. No statistical or simulation model exist to forecast the evolution of childhood asthma in Europe. Such a model needs to incorporate the main risk factors that can be managed by medical authorities, such as tobacco (OR = 1.44), to establish how they affect the present generation of children. A simulation model using conditional probability and discrete event simulation for childhood asthma was developed and validated by simulating realistic scenario. The parameters used for the model (input data) were those found in the bibliography, especially those related to the incidence of smoking in Spain. We also used data from a panel of experts from the Hospital del Mar (Barcelona) related to actual evolution and asthma phenotypes. The results obtained from the simulation established a threshold of a 15-20% smoking population for a reduction in the prevalence of asthma. This is still far from the current level in Spain, where 24% of people smoke. We conclude that more effort must be made to combat smoking and other childhood asthma risk factors, in order to significantly reduce the number of cases. Once completed, this simulation methodology can realistically be used to forecast the evolution of childhood asthma as a function of variation in different risk factors.
References
Duelo-Marcos M. El niño asmático visto desde la pediatría general. Revista de Patología Respiratoria 2007; 10(Suppl 1): 17-9.
García-Marcos Álvarez L, Guillén-Pérez JJ. Infección y asma. Cuál es su relación? An Pediatr (Barc) 2002; 56(Suppl 2): 31-5.
Akinbami LJ, Schoendorf KC. Trends in Childhood Asthma: Prevalence, Health Care Utilization, and Mortality. Pediatrics 2002; 110(2 Pt 1): 315-22. http://dx.doi.org/10.1542/peds.110.2.315 DOI: https://doi.org/10.1542/peds.110.2.315
Escamilla JM. Asma infantil. Algunas consideraciones terapéuticas. Revista de Neumología 2001; 13(3): 38-43.
Díaz-Vázquez C, Carvajal Urueña I, Domínguez-Aurrecoechea B, Mora-Gandarillas I, Morel-Bernabé JJ. Historia Natural del Asma. Determinantes del asma. In: Cano A, Diaz C, Monton JL editors. Asma en el Niño y Adolescente. Madrid: Ergon 2004; p. 345-57.
Burchfiel CM, Higgins MW, Keller JB, Howatt WF, Butler WJ, Higgins I. Passive smoking in childhood. Respiratory conditions and pulmonary function in Tecumseh, Michigan. Am Rev Resp Dis 1986; 133: 966-73.
Weitzman M, Gortmaker S, Sobol A. Maternal smoking and behavior problems of children. Pediatrics 1992; 90: 342-9. DOI: https://doi.org/10.1542/peds.90.3.342
Martinez FD, Cline M, Burrows B. Increased incidence of asthma in children of smoking mothers. Pediatrics 1992; 89: 21-6. DOI: https://doi.org/10.1542/peds.89.1.21
Office of Health and Environmental Assessment, Office of Research and Development. EPA/600/6-90/006F: Respiratory health effects of passive smoking: lung cancer and other disorders. U.S. Environmental Protection Agency: Washington, D.C. 1992.
US Department of Health and Human Services: Smoking and tobacco control. National Cancer Institute (NCI): Health effects of exposure to environmental tobacco smoke: The Report of the California Environmental Protection Agency. Monograph Nº10 (Bethesda, MD). National Institutes of Health Washington, D.C., 1999.
Cunningham J, O'Connor GT, Dockery DW, Speizer FE. Environmental tobacco smoke, wheezing, and asthma in children in 24 communities. Am J Respir Crit Care Med 1996; 153: 218-24. http://dx.doi.org/10.1164/ajrccm.153.1.8542119 DOI: https://doi.org/10.1164/ajrccm.153.1.8542119
12. Jaakkola JJ, Nafstad P,Magnus P. Environmental Tobacco Smoke, Parental Atopy, and Childhood Asthma. Environ Health Perspect 2001; 109: 579-82.
13. Mannino DM, Homa DM, Redd SC. Involuntary Smoking and Asthma Severity in Children: Data from the Third National Health and Nutrition Examination Survey. Chest 2002; 122: 409-15.
[12] 14World Health Organization. The European tobacco control report 2007 (January 15, 2007). Tobacco Control. WHO Tobacco Control Papers. Paper Europe 2007. Available from http://repositories.cdlib.org/tc/whotcp/Europe2007 [June 7, 2013]
[13] 15Franchini M, Caruso C, Perico A, et al. Assessing fetal exposure to cigarette smoke after recent implementations of smoke-free policy in Italy. Acta Paediatr 2008; 97: 546-50. http://dx.doi.org/10.1111/j.1651-2227.2008.00762.x DOI: https://doi.org/10.1111/j.1651-2227.2008.00762.x
[14] 16Spanish Ministry of Health and Consumption (Ministerio de Sanidad y Consumo). Encuesta Nacional de Salud de España 2006; Available from: ww1.msc.es/salud/epidemiolo-gia/ies/encuesta2006/encuesta.htm [June 7, 2013]
[15] 17Spanish Ministry of Health and Consumption (Ministerio de Sanidad y Consumo). Encuesta Nacional de Salud de España 1993 Secretaría General Técnica: Madrid, 1995.
[16] 18Spanish Ministry of Health and Consumption (Ministerio de Sanidad y Consumo). Encuesta Nacional de Salud de España 1995. Secretaría General Técnica: Madrid, 1996.
[17] 19Spanish Ministry of Health and Consumption (Ministerio de Sanidad y Consumo). Encuesta Nacional de Salud de España 1997. Secretaría General Técnica: Madrid, 1999.
[18] 20Spanish Ministry of Health and Consumption (Ministerio de Sanidad y Consumo). Encuesta Nacional de Salud de España 2001. Available from: ww1.msc.es/salud/epidemiolo-gia/ies/encuesta2001/encuesta.htm [June 7, 2013]
[19] 21Spanish Observatory on Drugs. Encuesta sobre drogas a población escolar. Delegación del Gobierno para el Plan Nacional Sobre Drogas, Ministerio del Interior: Madrid, 2003.
[20] 22Spanish Centre for Sociological Research (CIS), Spanish Presidency Minister. Tabaquismo y nueva normativa antitabaco 2006. Ref. 2665. Available from: www.cis.es [June 7, 2013]
[21] 23Balemans WA, van der Ent CK, Schilder AG, Sanders EA, Zielhuis GA, Rovers MM. Prediction of asthma in young adults using childhood characteristics: Development of a prediction rule. J Clin Epidemiol 2006; 59: 1207-12. http://dx.doi.org/10.1016/j.jclinepi.2006.02.011 DOI: https://doi.org/10.1016/j.jclinepi.2006.02.011
24. Stein RT, Martinez FD. Asthma phenotypes in childhood: lessons from an epidemiological approach. Paediatr Respir Rev 2004; 5: 155-61. DOI: https://doi.org/10.1016/j.prrv.2004.01.007
25. Sargent RG. Verification, validation, and accreditation of simulation models, Proceedings of the 2000 Winter Simulation Conference. Available from: http://www.wintersim.org/ [June 7, 2013]
[22] 26Kahn HA, Sempos CT. Statistical Methods in Epidemiology. New York: Oxford University Press; 1989; p. 292.
[23] 27Gail MH, Benichou J. Encyclopedia of Epidemiologic Methods. New York: Wiley Press 2000.
[24] 28Clayton D, Hills M. Statistical Models in Epidemiology. Oxford: Oxford University Press 1993.
[25] 29Monleón A. Introducción a la simulación de ensayos clínicos. Barcelona: Publicaciones y Ediciones UB. 2008.
[26] 30Rodríguez-Barrios JM, Serrano D, Monleón T, Caro J. Discrete Event Simulation Models in the Economic
Evaluation of Health Technologies and Health Products. Gac Sanit 2008; 22: 151-61.
Sargent RG. Verification, validation, and accreditation of simulation models, Proceedings of the 2000 Winter Simulation Conference. Available from: http://www.wintersim. org/ [June 7, 2013]
[28] Jaakkola JJ, Nafstad P, Magnus P. Environmental Tobacco Smoke, Parental Atopy, and Childhood Asthma. Environ Health Perspect 2001; 109: 579-82. http://dx.doi.org/10.1289/ehp.01109579 DOI: https://doi.org/10.1289/ehp.01109579
[29] Mannino DM, Homa DM, Redd SC. Involuntary Smoking and Asthma Severity in Children: Data from the Third National Health and Nutrition Examination Survey. Chest 2002; 122: 409-15. http://dx.doi.org/10.1378/chest.122.2.409 DOI: https://doi.org/10.1378/chest.122.2.409
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2013 T. Monleón-Getino, C. Puig, O. Vall, M. Ríos, A. Chiandetti, O. Garcia-Algar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
