A Disease Model for Wheezing Disorders in Preschool Children Based on Clinicians Perceptions 英文参考文献.docVIP

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A Disease Model for Wheezing Disorders in Preschool Children Based on Clinicians Perceptions 英文参考文献.doc

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A Disease Model for Wheezing Disorders in Preschool Children Based on Clinicians Perceptions 英文参考文献

ADiseaseModelforWheezingDisordersinPreschool ChildrenBasedonClinicians’Perceptions BenD.Spycher1*,MichaelSilverman2,JuergBarben3,ErnstEber4,Ste′phaneGuinand5,MarkL.Levy6, CarolinePao7,WillemM.vanAalderen8,OnnoC.P.vanSchayck9,ClaudiaE.Kuehni1 1InstituteofSocialandPreventiveMedicine(ISPM),UniversityofBern,Bern,Switzerland,2DepartmentofInfection,ImmunityandInflammation,UniversityofLeicester, Leicester, United Kingdom, 3Department of Pulmonology and Allergology, Children’s Hospital St. Gallen, St. Gallen, Switzerland, 4Respiratory and Allergic Disease Division, Paediatric Department, Medical University of Graz, Graz, Austria, 5Pulmonology Unit, Department of Paediatrics, Geneva University Hospital, Geneva, Switzerland, 6Allergy and Respiratory Research Group, Division of Community Health Sciences: GP Section, Edinburgh University, Edinburgh, United Kingdom, 7DepartmentofPaediatrics,BartsandtheLondonChildren’sHospital,London,UnitedKingdom,8DepartmentofPaediatricRespiratoryMedicineandAllergy,Emma Children’sHospital,AcademicMedicalCentre,Amsterdam,TheNetherlands,9DepartmentofGeneralPractice,MaastrichtUniversity,Maastricht,TheNetherlands Abstract Background:Wheezingdisordersinchildhoodvarywidelyinclinicalpresentationanddiseasecourse.Duringthelastyears, severalwaystoclassifywheezingchildrenintodifferentdiseasephenotypeshavebeenproposedandareincreasinglyused forclinicalguidance,butvalidationofthesehypotheticalentitiesisdifficult. Methodology/Principal Findings: The aim of this study was to develop a testable disease model which reflects the full spectrum of wheezing illness in preschool children. We performed a qualitative study among a panel of 7 experienced cliniciansfrom4Europeancountriesworkinginprimary,secondaryandtertiarypaediatriccare.Inaseriesofquestionnaire surveys and structured discussions, we found a general consensus that preschool wheezing disorders consist of several phenotypes,withagreatheterogeneityofspecificdiseaseconceptsbetweenclinicians.Initially,24dise