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Development and validation of a 5-day-ahead hay fever forecast for patients with grass-pollen-induced allergic rhinitis
Authors:Letty A de Weger  Thijs Beerthuizen  Pieter S Hiemstra  Jacob K Sont
Institution:1. Department of Pulmonology, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, 2300RC, Leiden, The Netherlands
2. Department of Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
Abstract:One-third of the Dutch population suffers from allergic rhinitis, including hay fever. In this study, a 5-day-ahead hay fever forecast was developed and validated for grass pollen allergic patients in the Netherlands. Using multiple regression analysis, a two-step pollen and hay fever symptom prediction model was developed using actual and forecasted weather parameters, grass pollen data and patient symptom diaries. Therefore, 80 patients with a grass pollen allergy rated the severity of their hay fever symptoms during the grass pollen season in 2007 and 2008. First, a grass pollen forecast model was developed using the following predictors: (1) daily means of grass pollen counts of the previous 10 years; (2) grass pollen counts of the previous 2-week period of the current year; and (3) maximum, minimum and mean temperature (R 2?=?0.76). The second modeling step concerned the forecasting of hay fever symptom severity and included the following predictors: (1) forecasted grass pollen counts; (2) day number of the year; (3) moving average of the grass pollen counts of the previous 2 week-periods; and (4) maximum and mean temperatures (R 2?=?0.81). Since the daily hay fever forecast is reported in three categories (low-, medium- and high symptom risk), we assessed the agreement between the observed and the 1- to 5-day-ahead predicted risk categories by kappa, which ranged from 65 % to 77 %. These results indicate that a model based on forecasted temperature and grass pollen counts performs well in predicting symptoms of hay fever up to 5 days ahead.
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