Banca de DEFESA: ANA CLARA PAIXAO CAMPOS

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : ANA CLARA PAIXAO CAMPOS
DATA : 29/04/2019
HORA: 14:00
LOCAL: Auditório do Instituto de Saúde Coletiva
TÍTULO:

COURSE OF ASTHMA SYMPTOMS BETWEEN CHILDHOOD AND ADOLESCENCE: USES, LIMITS AND PERSPECTIVES OF ANALYSIS STRATEGIES IN LONGITUDINAL STUDIES

PALAVRAS-CHAVES:

Asthma symptoms, Longitudinal data, Missing data, Latent Transition Analysis.

PÁGINAS: 240
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
SUBÁREA: Epidemiologia
RESUMO:

Despite efforts to identify risk / protective factors for asthma / asthma symptoms, the etiology of the disease remains poorly understood, as well as its dynamics over time, especially in the transition from childhood to adolescence. Initially, a systematic review was conducted on the use of statistical methods in longitudinal studies of asthma over the last 20 years. We identified 45 epidemiological studies that demonstrated the limited use of statistical methods for longitudinal data, where repeated measurements of the outcome are available, and, consequently, of studies that longitudinally assessed the risk factors associated with the occurrence of asthma / asthma symptoms at various stages of life, such as childhood and adolescence. We also analyzed data from a longitudinal study about asthma called Social Changes, Asthma and Allergy in Latin America Project (SCAALA-Salvador), where participants were followed up from childhood to adolescence in order to evaluate the effect of risk factors on the longitudinal occurrence of asthma / asthma symptoms throughout the childhood and adolescence. For data analysis we used three advanced statistical techniques for modeling data with repeated measures. Additionally, the impact of missing data on the analysis of longitudinal asthma data was evaluated. We used multiple imputation as a strategy to deal with missing data on the covariates and in the outcome, considering different missing percentages and missing data mechanisms In general, estimates from the logistic GEE and from the multilevel logistic models were consistent in the same direction, demonstrating the deleterious effect of atopy, maternal asthma and maternal common mental disorder on the occurrence of asthma symptoms over time. The analysis with missing data and multiple imputation showed that the presence of missing on the covariate is more detrimental than the missing in the outcome, and that if a single variable presents a high percentage of missing data, the estimates obtained using the imputation can be invalid.
Finally, Latent Class Analysis (LCA) was used to define asthma phenotypes in childhood and adolescence. Latent Transition Analysis (LTA), in its turn, was used to explore the longitudinal patterns of asthma, evaluating the transitions between such phenotypes and the effect of predictors associated with the longitudinal occurrence of asthma symptoms. The phenotypes were named healthy and symptomatic. About 5% of healthy individuals in childhood became symptomatic in middle childhood, the same having been observed in the transition from middle childhood to adolescence. Common maternal mental disorder was pointed out as a risk factor for less healthy states in both childhood and adolescence. Longitudinal studies are essential for the study of asthma, since its natural history remains poorly understood, as there is still no consensus on the factors that contribute to its dynamics over time. Asthma is the most common disease in childhood, and responsible for high costs to the health system, thus the identification of associated factors can substantially contribute to the formulation of strategies aimed not only at the prevention of the disease, but its control during children and adolescent’s development.

MEMBROS DA BANCA:
Externo à Instituição - ALINE ARAUJO NOBRE
Externo ao Programa - 109.796.035-87 - ALVARO AUGUSTO SOUZA DA CRUZ FILHO - UFBA
Interno - 2195844 - LEILA DENISE ALVES FERREIRA AMORIM
Interno - 118.180.505-87 - MAURICIO LIMA BARRETO - UFBA
Interno - 287722 - ROSEMEIRE LEOVIGILDO FIACCONE