Hypotheses of the ADEM2 study
exacerbations, airway remodelling, asthma-like symptoms, wheezing, allergy, asthma, wheeze
ALLERGY, ASTHMA, SEQUELA
The hypothesis of the clinical trial of the ADEM2 study is that application of the breath test in preschool children with asthma-like symptoms will result in important health gain and reduction of costs of care. In children with asthma, we expect that an early diagnosis by the breath test will result in more targeted and better treatment. This will facilitate better asthma control, improved lung function, less exacerbations, less hospital admissions, improved quality of life, and probably less airway remodelling. In children with transient wheeze, we hypothesise that an early diagnosis will diminish uncertainty of parents and treating doctors, with less referrals, less additional examinations (X-rays, allergy tests, microbial cultures or viral PCR tests), and less ineffective treatment (antibiotics, corticosteroids, or antihistamines). Parents will be reassured by the early diagnosis of transient wheeze, which will probably increase quality of life and decrease medical consumption. In both cases, cost savings are expected because of a proper diagnosis by the breath test due to significantly reduced hospital based care and medication use in children with transient wheeze, and prevention of undertreatment related sequela in children with asthma.Our hypothesis of the observational cohort study with respect to the feasibility, reproducibility and accuracy of the alternative VOC-sensing techniques is that innovative techniques such as SIFT-MS are not inferior to the current golden standard GC–MS. We also hypothesise that new (combinations of) biomarkers will be found that improve the diagnostic accuracy to identify the wheezing preschool child developing asthma, such as epigenetic signatures of blood eosinophils, microbiome data of both nasopharyngeal swabs and faecal samples, whole RNA sequencing on blood, gene-expression of relevant asthma genes, and immunological markers.