Multi-level Modelling of International Variations and Time Trends in Asthma and Allergic Diseases in Children and Adults

儿童和成人哮喘和过敏性疾病的国际变化和时间趋势的多层次建模

• 批准号: 1784617
• 金额: --
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2016
• 资助国家: 英国
• 起止时间: 2016 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-1784617
• 关键词: Multi; level; Modelling; International; Variations

This project will combine substantive research into asthma causes and time trends with developing statistical methodologies to handle complex multi-level datasets.The main data sources are from three linked studies:Phase I (1992-1995) of the International Study of Asthma and Allergies in Childhood (ISAAC) collected information by questionnaire on symptoms and risk factors for asthma, rhinoconjunctivitis and eczema from 721,602 children in 155 collaborating centres in 56 countries. Phase III (2001-2002) of ISAAC collected similar information from 1,187,496 children in 237 centres in 98 countries. The Global Asthma Network (GAN) will use the ISAAC methodology to collect similar data during 2016-2017 but with the extension of data on parents and extra questions on asthma management and the environment. To date, 88 centres from 34 countries have registered for GAN and registration is ongoing.The type of data collected for the studies includes information on symptoms and severity along with environmental and demographic data for three different age groups, one in childhood, one teenage and one adult. This fits in well with the MRC strategic research aims of investigating health through the life course, and understanding how lifestyles and environment affect health. Within each country at least one urban and one rural centre will be sought so the influence of the general environment on asthma can be explored. A sample size of at least 3,000 people per age group per centre will be used to give sufficient power to detect differences in the severity of asthma. In smaller island populations, all pupils in the age group and their parents will be selected.Starting with the existing ISAAC surveys, which have yet to be fully exploited with state-of-the-art statistical modelling techniques, and later combining it with the GAN survey data it will be possible to run integrated analysis on all three studies. This complex multi-level structure will contain multiple exposures on 3 age groups, at 4 different levels (person, school, centre and country) across up to 3 time points. For some centres there will be missing age groups and/or missing time points which will need to be addressed correctly to ensure the statistical inference is robust. This aligns well with the MRC skills priorities of quantitative and interdisciplinary skills by combining the development of novel statistical methodologies for large, multi-level datasets with their application on epidemiological questions of potential causes or risk factors for asthma and other allergic diseases.The results of this project should be useful to public health officials within multiple countries. Understanding the important risk factors at different levels improves the ability to positively impact the prevalence and severity of asthma and other allergic diseases through changing health policies. Outcomes will vary widely from country to country and this work will help estimate the impact of potential policy changes. In addition, the methodological developments will be useful for statisticians working in other areas of health research but with similarly constructed multi-level datasets.

该项目将联合收割机结合对哮喘病因和时间趋势的实质性研究，并发展统计方法，以处理复杂的多层次数据集，主要数据来源于三项相关研究：第一阶段（1992-1995年）的国际儿童哮喘和过敏研究（ISAAC）通过问卷调查收集了56个国家155个合作中心721 602名儿童的哮喘、鼻结膜炎和湿疹症状和危险因素的信息。国际审计咨询委员会第三阶段（2001-2002年）从98个国家的237个中心的1 187 496名儿童收集了类似信息。全球哮喘网络（GAN）将在2016-2017年期间使用ISAAC方法收集类似的数据，但扩展了关于父母的数据以及关于哮喘管理和环境的额外问题。迄今为止，来自34个国家的88个中心已注册GAN，注册正在进行中，为研究收集的数据类型包括三个不同年龄组的症状和严重程度信息沿着环境和人口数据，一个是儿童，一个是青少年，一个是成年人。这与MRC的战略研究目标非常吻合，即通过生命过程调查健康，并了解生活方式和环境如何影响健康。在每个国家内，将至少寻找一个城市和一个农村中心，以便探索一般环境对哮喘的影响。将使用每个中心每个年龄组至少3，000人的样本量，以提供足够的把握度来检测哮喘严重程度的差异。在人口较小的岛屿，将选择该年龄组的所有学生及其父母，从目前尚未充分利用最新统计建模技术的ISAAC调查开始，然后将其与GAN调查数据结合起来，就有可能对所有三项研究进行综合分析。这一复杂的多层次结构将包含3个年龄组、4个不同层次（个人、学校、中心和国家）、最多3个时间点的多重暴露。对于某些中心，将存在缺失的年龄组和/或缺失的时间点，需要正确解决这些问题，以确保统计推断的稳健性。这与MRC的定量和跨学科技能的技能优先级相一致，通过将大型多层次数据集的新统计方法的开发与其在哮喘和其他过敏性疾病的潜在原因或风险因素的流行病学问题上的应用相结合，该项目的结果应该对多个国家的公共卫生官员有用。了解不同层面的重要风险因素，可以通过改变卫生政策，提高对哮喘和其他过敏性疾病的患病率和严重程度产生积极影响的能力。结果将因国家而异，这项工作将有助于估计潜在政策变化的影响。此外，方法的发展将是有益的统计工作者在其他领域的健康研究，但同样构建多层次的数据集。

项目成果

Are Environmental Factors for Atopic Eczema in ISAAC Phase Three due to Reverse Causation?

ISAAC 第三阶段中特应性湿疹的环境因素是否是反向因果关系？

• DOI: 10.1016/j.jid.2018.08.035
• 发表时间: 2019
• 期刊: The Journal of investigative dermatology
• 作者: Rutter CE

Are environmental risk factors for current wheeze in the International Study of Asthma and Allergies in Childhood (ISAAC) phase three due to reverse causation?

国际儿童哮喘和过敏研究 (ISAAC) 第三阶段中当前喘息的环境风险因素是否是由于反向因果关系造成的？

• DOI: 10.1111/cea.13325
• 发表时间: 2019
• 期刊: journal of the British Society for Allergy and Clinical Immunology
• 作者: Silverwood RJ

Global Asthma Network Phase I Surveillance: Geographical Coverage and Response Rates.

• DOI: 10.3390/jcm9113688
• 发表时间: 2020-11-17
• 期刊: Journal of clinical medicine
• 影响因子: 3.9
• 作者: Ellwood P;Ellwood E;Rutter C;Perez-Fernandez V;Morales E;García-Marcos L;Pearce N;Asher MI;Strachan D;On Behalf Of The Gan Phase I Study Group
• 通讯作者: On Behalf Of The Gan Phase I Study Group