{
  "abstract": "Introduction Preschool wheeze and asthma are associated with substantial morbidity and impaired future lung function. Yet, wheeze is unreliably reported with high disagreement (>50%) between parental and physician observations. Objectively defining wheeze and its reversibility could enable an earlier asthma diagnosis and improve preschool wheeze management.Our primary aim is to determine in preschool children (aged 0.5–6 years) suspected of asthma whether adding WheezeScan to routine clinical assessment (vs assessment without WheezeScan) improves the diagnosis of asthma. Our primary hypothesis is that using WheezeScan in preschool children suspected of asthma is associated with increased definitive asthma diagnoses in this age group. Our secondary aims are to (a) examine the effect of using WheezeScan on patient-reported outcomes (PROs) and (b) healthcare costs. Our secondary hypothesis is that using WheezeScan in preschool children suspected of asthma is associated with improved quality of life without incurring additional healthcare costs.Methods and analysis Our multicentre prospective cohort study involves recruiting 102 preschool children suspected of asthma. WheezeScan, a user-friendly digital device, incorporates artificial intelligence to objectively define wheeze and its response to bronchodilators. Over 6 weeks, parents/caregivers use the WheezeScan two times per day and whenever wheezing is suspected. If wheeze is detected, an inhaled short-acting β 2-agonist is administered and WheezeScan determines if wheeze resolves thereafter.Our primary endpoint is the proportion of children with a definitive asthma diagnosis, compared with baseline, based on the treating clinician’s assessment using WheezeScan data. Our secondary outcomes are PROs, reflecting generic health-related quality-of-life and cough-specific (if chronic cough present) outcomes and health costs.Ethics and dissemination The Children’s Health Queensland Human Research Ethics Committee (HREC/23/QCHQ/100691) and the Queensland University of Technology Office of Research Ethics and Integrity approved the study. We will publish and share results with the academic and healthcare communities and relevant patient organisations.Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12623000904673.",
  "authors": [
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia",
        "Cough, Asthma and Airways Group, Australian Centre for Health Services Innovation and School of Medicine, Queensland University of Technology, Brisbane, Queensland, Australia"
      ],
      "name": "Anne B Chang"
    },
    {
      "affiliations": [
        "Cough, Asthma and Airways Group, Australian Centre for Health Services Innovation and School of Medicine, Queensland University of Technology, Brisbane, Queensland, Australia",
        "Menzies School of Health Research, Darwin, Northern Territory, Australia"
      ],
      "name": "Stephanie T Yerkovich"
    },
    {
      "affiliations": [
        "School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, 1. Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Brisbane, Queensland, Australia",
        "Metro South Health, Clinical Informatics Directorate, Woollongabba, Queensland, Australia"
      ],
      "name": "Steven McPhail"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia",
        "Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Hiran Selvadurai"
    },
    {
      "affiliations": [
        "Australian Centre for Health Services Innovation, Kelvin Grove, Queensland, Australia",
        "Queensland Children’s Hospital, South Brisbane, Queensland, Australia"
      ],
      "name": "Vikas Goyal"
    },
    {
      "affiliations": [
        "Emergency Department, Gold Coast University Hospital, Southport, Gold Coast, Australia",
        "School of Medicine and Dentistry, Griffith University, Brisbane, Queensland, Australia"
      ],
      "name": "Shane George"
    },
    {
      "affiliations": [
        "Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia"
      ],
      "name": "Gabrielle B McCallum"
    },
    {
      "affiliations": [
        "Child Health Division, Darwin, Northern Territory, Australia",
        "Menzies School of Health Research, Casuarina, Northern Territory, Australia"
      ],
      "name": "Peter S Morris"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia",
        "School of Medicine, Queensland University of Technology, Brisbane, Queensland, Australia"
      ],
      "name": "Hannah O’farrell"
    },
    {
      "affiliations": [
        "Child Health Division, Darwin, Northern Territory, Australia",
        "Child and Maternal Health, Menzies School of Health Research, Casuarina, Northern Territory, Australia"
      ],
      "name": "Lesley Versteegh"
    },
    {
      "affiliations": [
        "Academic Unit of Paediatrics, Queen Mary University London, London, UK"
      ],
      "name": "Jonathan Grigg"
    },
    {
      "affiliations": [
        "Queensland University of Technology Centre for Children’s Health Research, Brisbane, Queensland, Australia",
        "Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, South Brisbane, Queensland, Australia"
      ],
      "name": "Margaret McElrea"
    },
    {
      "affiliations": [
        "School of Medicine, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia"
      ],
      "name": "Sophie Worley"
    },
    {
      "affiliations": [
        "Parent Advisory Group Representative, Cough, Asthma and Airways Group, Australian Centre for Health Services Innovation and School of Clinical Medicine, Queensland University of Technology Faculty of Health, Brisbane, Queensland, Australia"
      ],
      "name": "Terase Yerkovich"
    },
    {
      "affiliations": [
        "Asthma Foundation of the Northern Territory, Darwin, Northern Territory, Australia"
      ],
      "name": "Leanne Elliot-Holmes"
    },
    {
      "affiliations": [
        "Parent Advisory Group Representative, Cough, Asthma and Airways Group, Australian Centre for Health Services Innovation and School of Clinical Medicine, Queensland University of Technology, Brisbane, Queensland, Australia"
      ],
      "name": "Joanna Williams"
    },
    {
      "affiliations": [
        "School of Medicine and Dentistry, Griffith University, Griffith Health, Gold Coast, Queensland, Australia",
        "Child and Maternal Health, Menzies School of Health Research, Darwin, Northern Territory, Australia"
      ],
      "name": "Keith Grimwood"
    },
    {
      "affiliations": [
        "Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, South Brisbane, Queensland, Australia",
        "Australian Centre for Health Services Innovation and School of Clinical Medicine, Queensland University of Technology Faculty of Health, Brisbane, Queensland, Australia"
      ],
      "name": "Julie M Marchant"
    }
  ],
  "title": "Improving the management and outcomes of preschool wheeze: protocol of a prospective multicentre cohort study",
  "uid": "0687217c-d76a-5e51-b0ce-256794917991"
}