COMPARABILITY OF PARENT REPORTS OF RESPIRATORY ILLNESSES WITH CLINICAL DIAGNOSES IN INFANTS

In a cohort study of respiratory illnesses from birth through age 18 m onths, the investigators assessed the occurrence of illness by telepho ne reports of respiratory symptoms. To assess the comparability of ill ness events based on symptom reports with usual clinical modalities, a nurse practitioner examined children during illnesses, and office and clinic records of outpatient visits were reviewed. Respiratory illnes ses were defined as symptom episodes of at least 2 days; lower respira tory illnesses included at least 1 day of either wet cough or wheeze. This report is based on 10,771 illnesses in the 1,315 subjects enrolle d. Runny or stuffy nose was reported for most (93%) illnesses, wet cou gh in 33%, and wheeze in 6%. In comparison with the diagnoses made by a nurse practitioner, parent report of wet cough or wheeze was sensiti ve (93.4%) for detecting lower respiratory illnesses, but nonspecific with specificity of only 24.2%. The majority of the false-positive low er respiratory illnesses had the symptom of wet cough. The comparison of parent reports with outpatient records provided similar findings. S tandardized reporting of respiratory illnesses can be achieved with a telephone surveillance system but classification of specific illnesses from the surveillance information may differ from diagnoses made by c linicians.