| 11. |
- Hedman, Linnea, et al.
(författare)
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Agreement between parental and self-completed questionnaires about asthma in teenagers
- 2005
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Ingår i: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 16:2, s. 176-181
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Tidskriftsartikel (refereegranskat)abstract
- In studies of asthma in children, a common method is for the parents to complete questionnaires about their child's asthma symptoms. With longitudinal studies of asthma, children reach an age when they can complete the questionnaire themselves. The aim of this paper was to compare the prevalence of asthma symptoms as well as the agreement between responses to an asthma questionnaire completed by teenagers and their parents. As a part of the Obstructive Lung Disease in Northern Sweden Study (OLIN) pediatric study, where 3345, 13-14-yr-old children completed an asthma questionnaire, 294 (84%) randomly selected parents also completed the questionnaire, which included the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. There were no significant differences in the prevalence of wheeze in the last 12 months, ever asthma, or physician diagnosed asthma as reported by the parents compared with the teenagers. However, the teenagers reported a significantly higher prevalence of wheeze during or after exercise. The absolute agreement was generally very high while the level of agreement (kappa-value) was slightly lower. The highest results in both absolute agreement and kappa-value, were reached by the questions on diagnosis of asthma (98.9% and 0.93), use of asthma medicines (95.5% and 0.78), and whether the child ever had had asthma (97.2% and 0.86), respectively. In conclusion, the agreement between the parents' and the teenagers' responses to the asthma questionnaire was good. The change in methodology from parental to self-completion of the questionnaire did not affect the results in the study.
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| 12. |
- Hedman, Linnéa, 1979-, et al.
(författare)
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Factors related to tobacco use among teenagers.
- 2007
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Ingår i: Respiratory medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 101:3, s. 496-502
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To examine tobacco use among teenagers, identify factors related to tobacco use, as well as evaluate the outcome of a smoking prevention program. METHODS: From age 7/8 to 14/15, annual questionnaires about asthma and allergy have been completed in the OLIN paediatric study in Northern Sweden. From 12/13 years, questions about tobacco use, i.e. smoking and snuff, were added. A smoking prevention program was performed during 2 years. RESULTS: Any tobacco use increased from 5.0% at age 12/13 years, to 14.4% at age 14/15. At age 14/15 years, the prevalence of tobacco use was significantly higher among boys than girls (16.7 and 12.0%, respectively). More girls than boys smoked (8.9 and 2.8%, respectively), while use of snuff was more common among the boys (15.6 and 4.2%, respectively). Significant risk factors for smoking were any of the family members currently smoking, OR 6.1 (95% CI 4.0-9.3) and a physician-diagnosed asthma at the age of 14/15 years, OR 1.9 (95% CI 1.2-3.0). A protective factor against tobacco use was participation in sports, OR 0.3 (95% CI 0.2-0.4). The prevention program did not result in less tobacco use, although it may have delayed smoking initiation. CONCLUSION: The patterns of tobacco use differed significantly between boys and girls. Though any tobacco use was more common among boys, girls were more likely to smoke, and boys were more likely to use snuff. Having asthma did not prevent the teenagers from smoking. Since having a smoking family member was the major risk factor for tobacco use, prevention programs should be directed at smoking families in addition to the individuals.
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| 13. |
- Jansson, Sven-Arne, et al.
(författare)
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Cost differences for COPD with and without physician-diagnosis.
- 2005
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Ingår i: COPD. - 1541-2555. ; 2:4, s. 427-34
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have presented divergent estimates of the cost of illness of COPD due to differences in methodology. The objective of this study was to examine differences between register-based estimates versus population-based estimates on the burden of COPD. This study therefore examined differences in costs of COPD among physician-diagnosed and un-diagnosed subjects. During a one-year period, four telephone interviews were made with 212 randomly selected subjects with COPD derived from the Obstructive Lung Disease in Northern Sweden (OLIN) studies. Health care resource utilization and productivity losses were measured, and the costs were also transformed with the estimated COPD prevalence in Sweden. Average annual costs were SEK 18,252 (USD 2,207, EUR 2,072), and SEK 9,327 (USD 1,128, EUR 1,059) for subjects with and without a physician-diagnosis, respectively. Although lower per individual, the costs of undiagnosed subjects accounted for approximately 40% of the total costs in Sweden, since the majority of subjects with COPD in Sweden lack a physician-diagnosed disease. In conclusion, we found that the costs due to COPD differed considerably between those with and without physician-diagnosed disease. This study indicates that register-based studies result in underestimated costs of COPD.
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| 14. |
- Jansson, Sven-Arne, et al.
(författare)
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Komorbiditet måste inkluderas vid beräkning av kostnader för KOL
- 2009
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Ingår i: Svenska läkaresällskapets handlingar: Hygiea. - 0349-1722. ; 118:1, s. 72-72
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BakgrundKroniskt obstruktiv lungsjukdom (KOL) är en av de vanligast förekommande sjukdomarna i Sverige och medför stort lidande för de drabbade. De samhällsekonomiska kostnaderna till följd av sjukdomen är höga. Syftet med denna studie var att beräkna det totala antalet sjukhusinläggningar för både KOL och för andra sjukdomar i en kohort av individer med respektive utan sjukdomen KOL.MetodStudiepopulationen är identifierad sedan tidigare i genomförda kliniska undersökningar av populationsbaserade kohorter inom OLIN-studierna (Obstruktiv Lungsjukdom i Norra Sverige). Kohorten innehöll ursprungligen 993 individer, vilka alla uppfyllde kriterierna för KOL; samt en lika stor ålders- och könsmatchad kontrollgrupp utan sjukdomen KOL. Dessa individer har sedan 2005 intervjuats årligen om deras resurskonsumtion i sjukvårdssektorn samt genomgått en klinisk undersökning. Deltagandegraden har årligen varit cirka 90 %.ResultatIndivider med KOL hade fler sjukhusinläggningar, både till följd av KOL och på grund av andra sjukdomar, jämfört med individer utan KOL (0.8 dagar respektive 1,1 dagar per individ och år). Trots att mer än 90% av individerna med KOL hade en mild eller medelsvår sjukdom visade studien att individer med KOL hade 25% fler dagar på sjukhus både för KOL och för andra sjukdomar jämfört med kontrollgruppen. Detta var oberoende av kön, men skillnaden var större bland män jämfört med kvinnor (0,4 dagar respektive 0,2 dagar per individ och år). Resultaten tyder på att komorbiditeten vid KOL är betydande.SammanfattningKostnader för KOL blir kraftigt underskattade om man inte tar hänsyn till kostnader för komorbiditiet. Beräkningar och analyser av resurskonsumtion och kostnader för komorbiditet måste därför genomföras för att erhålla den verkliga kostnaden för KOL.
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| 15. |
- Jansson, Sven-Arne, et al.
(författare)
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The economic consequences of asthma among adults in Sweden.
- 2007
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Ingår i: Respiratory medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 101:11, s. 2263-70
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Asthma is a common disease in most countries. The objective of this study was to estimate the societal costs for subjects with asthma. METHODS: Telephone interviews regarding resource utilization were made in a representative sample of 115 randomly selected subjects with asthma derived from a large population study of obstructive airway diseases. Direct and indirect costs were measured, and the costs were also transformed with the estimated prevalence of asthma in Sweden. RESULTS: Average annual costs were SEK 15919 (USD 1592; EUR 1768) per subject with asthma in the ages between 25 and 56 years. The direct and indirect costs were SEK 4931 (31.0%) and SEK 10988 (69.0%), respectively, and were highly dependent of age and disease severity. Assuming that the prevalence is representative for Sweden as a whole, the asthmatics would amount to 226000 in the ages between 25 and 56 years, corresponding to an overall prevalence in Sweden of 6-7%. The total costs of asthma for the society amounted thus to SEK 3.7 billion in these ages. CONCLUSIONS: The total costs of asthma for the society could be estimated at 3.7 billion SEK in the age range of 25-56 years, and thus approximately twice as high in the whole population of Sweden. The costs were strongly dependent on disease severity and increasing age.
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| 16. |
- Lindberg, Anne, et al.
(författare)
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10-year cumulative incidence of COPD and risk factors for incident disease in a symptomatic cohort
- 2005
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Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 127:5, s. 1544-1552
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Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVES: To determine the 10-year cumulative incidence of COPD in a cohort of subjects with respiratory symptoms (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage 0) using the British Thoracic Society (BTS) and GOLD spirometric criteria. Furthermore, we sought to evaluate risk and gender factors for incident COPD. DESIGN AND SETTING: A postal questionnaire was administered in 1986 to all 6,610 subjects in eight areas of northern Sweden who had been born in 1919 to 1920 (group 1), 1934 to 1935 (group 2), and 1949 to 1950 (group 3). The response rate was 86%. All of the subjects reporting respiratory symptoms were invited to participate in a structured interview and pulmonary function test (PFT), and 1,506 (91%) participated. In 1996, 90% could be traced for follow-up, of whom 1,165 (86%) of the invited subjects participated and 1,109 subjects (534 women) were able to perform technically adequate PFTs in both 1986 and 1996. RESULTS: The 10-year cumulative incidence of COPD was estimated at 8.2% (using BTS criteria) and 13.5% (using GOLD criteria). Significant risk factors for incident COPD (using BTS and GOLD criteria) in a multivariate analysis were higher age (group 1 odds ratio [OR]: BTS criteria, 3.49; GOLD criteria, 3.37; group 2 OR: BTS criteria, 4.50; GOLD criteria, 5.70) and smoking (OR: BTS criteria, 5.37; GOLD criteria, 4.56), but not gender or heredity. Respiratory symptoms were significantly associated with incident COPD when added to the same model. In analogous analyses that were conducted separately for men and women, smoking yielded an OR of 8.52 among women (95% confidence interval [CI], 3.43 to 21.2) compared with 3.14 among men (95% CI, 1.26 to 7.84). The symptoms cough, sputum production, and chronic productive cough reached statistical significance in women, while dyspnea and wheeze did so in men. CONCLUSION: In this cohort, the 10-year cumulative incidence of COPD was 8.2% (using BTS criteria) and 13.5% (using GOLD criteria). Increasing age, smoking, and bronchitic symptoms, but not gender, were risk factors for incident COPD. GOLD stage 0 therefore appears to identify subjects who are at risk of COPD, but men and women presented different risk profiles.
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| 17. |
- Lindberg, Anne, et al.
(författare)
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Decline in FEV1 in relation to incident chronic obstructive pulmonary disease in a cohort with respiratory symptoms.
- 2007
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Ingår i: COPD. - : Informa UK Limited. - 1541-2555. ; 4:1, s. 5-13
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Tidskriftsartikel (refereegranskat)abstract
- Data on the relationship between decline in lung function and development of COPD are sparse. We assessed the decline in FEV1 during 10 years among subjects with respiratory symptoms by two different methods and evaluated risk factors for decline and its relation to incident Chronic Obstructive Pulmonary Disease, COPD. A cross-sectional postal questionnaire was in 1986 sent to 6610 subjects of three age strata. All subjects reporting respiratory symptoms were invited to a structured interview and spirometry. A follow-up survey was performed 10 years later, and totally 1109 subjects performed spirometry in both 1986 and 1996. COPD was defined according to the ATS/ERS standards (FEV1/FVC < or =0.70). The decline in FEV1 was 39 ml/year in men vs. 28 ml/year in women, p = < 0.001 (-1.53 vs. -0.12 change in percent of predicted normal value over 10 years (pp), p = 0.023), among smokers 39 vs. non-smokers 28 ml/year, p < 0.001 (-3.30 vs. 0.69 pp, p < 0.001), in subjects with chronic productive cough 36 vs. not 32 ml/year, p = 0.044 (-2.00 vs. -0.02 pp, p = 0.002). Incident cases of moderate COPD (n = 83) had a decline of 62 ml/year (-12.6 pp) and 22.9% of them had a decline > 90 ml/year (-27.8 pp over 10 years). Gender-specific analysis revealed that smoking was a stronger risk factor in women than in men, while higher age was a significant risk factor in men only. In conclusion, decline in FEV1 was associated with age, smoking, and chronic productive cough, but the risk factor pattern was gender-dependent. Among incident cases of COPD the decline was steeper and close to a quarter had a rapid decline.
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| 18. |
- Lindberg, Anne, et al.
(författare)
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Prevalence and underdiagnosis of COPD by disease severity and the attributable fraction of smoking Report from the Obstructive Lung Disease in Northern Sweden Studies.
- 2006
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 100:2, s. 264-272
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a lack of epidemiological data on COPD by disease severity. We have estimated the prevalence and underdiagnosis of COPD by disease severity defined by the British Thoracic Society (BTS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The impact of smoking was evaluated by the population attributable fraction of smoking in COPD. METHODS: A random sample of 1500 responders of the third postal survey performed in 1996 of the Obstructive Lung Disease in Northern Sweden (OLIN) Studies' first cohort (6610 subjects recruited in 1985) were invited to structured interview and spirometry. One thousand two hundred and thirty-seven subjects (82%) performed spirometry. RESULTS: The prevalence of mild BTS-COPD was 5.3%, moderate 2.2%, and severe 0.6% (GOLD-COPD: mild 8.2%, moderate 5.3%, severe 0.7%, and very severe 0.1%). All subjects with severe COPD were symptomatic, corresponding figures among mild COPD were 88% and 70% (BTS and GOLD), Subjects with severe BTS-COPD reported a physician-diagnosis consistent with COPD in 50% of cases, in mild BTS-COPD 19%, while in mild GOLD-COPD only 5% of cases. The major risk factors, age and smoking, had a synergistic effect on the COPD-prevalence. The Odds Ratio (OR) for having COPD among smokers aged 76-77 years was 59 and 34 (BTS and GOLD) when non-smokers aged 46-47 was used as reference population. CONCLUSIONS: Most subjects with COPD have a mild disease. The underdiagnosis is related to disease-severity. Though being symptomatic, only a half of the subjects with severe COPD are properly labelled. Smoking and increasing age were the major risk factors and acted synergistic.
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| 19. |
- Lindberg, Anne, et al.
(författare)
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Prevalence of chronic obstructive pulmonary disease according to BTS, ERS, GOLD and ATS criteria in relation to doctor's diagnosis, symptoms, age, gender, and smoking habits.
- 2005
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Ingår i: Respiration. - : S. Karger AG. - 0025-7931 .- 1423-0356. ; 72:5, s. 471-9
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Guidelines and standards for diagnosis and management of chronic obstructive pulmonary disease (COPD) have been presented by different national and international societies, but the spirometric criteria for COPD differ between guidelines. <i>Objectives:</i> To estimate prevalence of COPD using the guidelines of the British Thoracic Society (BTS), the European Respiratory Society (ERS), the Global Initiative for Chronic Obstructive Lung Disease (GOLD), and the American Thoracic Society (ATS). Further, to evaluate reported airway symptoms, contacts with health care providers, and physician diagnosis of COPD in relation to the respective criteria, and gender differences. <i>Method:</i> In 1992 a postal questionnaire was sent to a random sample of adults aged 20–69 years, 4,851 (85%) out of 5,681 subjects responded. In 1994–1995 a random sample of the responders, 970 subjects, were invited to a structured interview and a lung function test; 666 (69%) participated. <i>Results:</i> The prevalence of COPD was 7.6, 14.0, 14.1, 12.2 and 34.1% according to BTS, ERS, GOLD, clinical ATS (with symptoms or physician diagnosis), and spirometric ATS criteria, respectively. Prevalent COPD was related to age, smoking habits and family history of obstructive airway disease but not to gender. Physician diagnosis of chronic bronchitis or emphysema was only reported by 16.3, 12.2, 11.0, 23.4 and 8.2% of subjects fulfilling the respective criteria, though a majority reported airway symptoms. <i>Conclusion:</i> The main determinants for prevalent COPD were age, smoking habits and spirometric criteria of COPD. Though a majority reported airway symptoms and contact with health care providers due to respiratory complaints, only a minority was diagnosed as having COPD, indicating a large underdiagnosis.
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| 20. |
- Lindberg, Anne, et al.
(författare)
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Seven-year cumulative incidence of COPD in an age-stratified general population sample.
- 2006
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Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 129:4, s. 879-885
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To estimate the cumulative incidence of COPD and risk factors related to the development of COPD, including evaluation of the relationship between Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 0 (ie, respiratory symptoms and normal lung function) and the development of COPD, in an age-stratified general population sample of middle-aged and elderly individuals. METHOD: The third survey of the Obstructive Lung Disease in Northern Sweden studies cohort I (three age strata born in 1919 to 1920, 1934 to 1935, and 1949 to 1950) was performed in 1996, and 5,189 subjects (88%) responded to the postal questionnaire. Of the responders, a random sample (1,500 subjects) was invited to an examination in 1996 and in 2003. A total of 963 subjects performed spirometry on both occasions. COPD was defined according to the spirometric criteria of the GOLD. Two levels of disease severity, grade I and higher (GOLD criteria, FEV(1)/FVC ratio of < 0.70) and also grade II and higher (GOLD II criteria, FEV(1)/FVC ratio of < 0.70 and FEV(1) <80% predicted). RESULTS: The 7-year cumulative incidence of COPD was 11.0% and 4.9%, respectively, according to GOLD and GOLD II, and was significantly related to smoking (smokers, 18.8% and 10.6%, respectively; ex-smokers, 10.5% and 5.2%, respectively; non-smokers, 7.6% and 1.6%, respectively). Incident COPD according to GOLD, but not according to GOLD II, was significantly associated with increasing age. Most respiratory symptoms at study entry were markers of increased risk for incident COPD when analyzed in a multivariate model adjusting for confounders. CONCLUSION: The GOLD criteria yielded a higher cumulative incidence (11.0%) compared to the GOLD II (4.9%). Smoking, but not gender, was associated with incident COPD. Most respiratory symptoms at the beginning of the observation period marked an increased risk for developing COPD, thus the classification GOLD stage 0 seems relevant among middle-aged and elderly persons.
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