Multilevel multivariable models of asthma severity algorithm, respiratory illness and not attaining the expected level at Key Stage 1 (at 6–7 years)
| Not attained/Total (%) | Unadjusted OR (95% CI) | Asthma severity algorithm Multivariable* OR (95% CI) | Wheeze severity algorithm Multivariable* OR (95% CI) | |
| N | 14 935/85 906 (17) | |||
| Asthma severity algorithm | ||||
| None (ref) | 12 733/75 156 (17) | Ref | Ref | NA |
| Diagnosis only | 134/532 (25) | 1.58 (1.29 to 1.95) | 1.21 (0.97 to 1.52) | NA |
| Intermittent bronchodilator | 444/2307 (19) | 1.11 (1.00 to 1.24) | 0.90 (0.79 to 1.01) | NA |
| Persistent mild | 1260/6247 (20) | 1.21 (1.13 to 1.30) | 0.97 (0.89 to 1.05) | NA |
| Persistent moderate | 298/1365 (22) | 1.36 (1.18 to 1.55) | 1.06 (0.91 to 1.24) | NA |
| Persistent severe | 66/299 (22) | 1.45 (1.09 to 1.93) | 1.02 (0.75 to 1.40) | NA |
| Hospital inpatient admission (acute asthma)†=yes (%) | 837/3487 (24) | 1.48 (1.36 to 1.61) | 1.14 (1.02 to 1.27) | NA |
| Wheeze severity algorithm | ||||
| None (ref) | 11 252/67 508 (17) | Ref | NA | Ref |
| Diagnosis only | 451/2237 (20) | 1.24 (1.11 to 1.39) | NA | 1.05 (0.94 to 1.19) |
| Intermittent bronchodilator | 1271/6465 (20) | 1.20 (1.12 to 1.28) | NA | 1.01 (0.94 to 1.08) |
| Persistent mild | 1582/7964 (20) | 1.22 (1.14 to 1.29) | NA | 0.97 (0.90 to 1.04) |
| Persistent moderate | 306/1407 (22) | 1.37 (1.20 to 1.57) | NA | 1.06 (0.91 to 1.23) |
| Persistent severe | 73/325 (23) | 1.53 (1.16 to 2.00) | NA | 1.08 (0.80 to 1.45) |
| Hospital inpatient admission (acute asthma or wheeze)†=yes (%) | 1112/4668 (24) | 1.48 (1.37 to 1.59) | NA | 1.14 (1.04 to 1.25) |
| LRTI‡ GP contacts§ (ref=none) | ||||
| 1 | 2729/15 759 (17) | 1.05 (1.00 to 1.10) | 1.01 (0.96 to 1.07) | 1.01 (0.96 to 1.06) |
| 2 | 1260/6803 (18) | 1.14 (1.07 to 1.22) | 1.05 (0.97 to 1.13) | 1.04 (0.97 to 1.12) |
| 3+ | 1421/6726 (21) | 1.33 (1.25 to 1.43) | 1.15 (1.06 to 1.24) | 1.14 (1.06 to 1.23) |
| URTI¶ GP contacts (ref=none) | ||||
| 1–4 | 7727/45 162 (17) | 0.98 (0.93 to 1.02) | 1.00 (0.95 to 1.05) | 1.00 (0.95 to 1.05) |
| 5–6 | 1483/8641 (17) | 1.00 (0.93 to 1.07) | 1.01 (0.94 to 1.09) | 1.01 (0.94 to 1.09) |
| 7+ | 1842/9790 (19) | 1.10 (1.03 to 1.17) | 1.08 (1.01 to 1.16) | 1.08 (1.00 to 1.16) |
| GP contacts | ||||
| Influenza and pneumonia 1+ (ref=None) | 436/2602 (17) | 0.96 (0.86 to 1.07) | NA | NA |
| Bronchiolitis 1+ (ref=none) | 884/4219 (21) | 1.26 (1.16 to 1.36) | 1.01 (0.93 to 1.10) | 1.00 (0.92 to 1.09) |
| Chronic lower respiratory disease 1+ (ref=none) | 156/633 (25) | 1.39 (1.15 to 1.69) | 1.18 (0.96 to 1.45) | 1.18 (0.96 to 1.45) |
| Unspecified respiratory illness 1+ (ref=none) | 69/475 (15) | 0.75 (0.57 to 0.98) | NA | NA |
| Chronic upper respiratory disease GP contacts (ref=none) | ||||
| 1 | 914/5372 (17) | 0.98 (0.91 to 1.06) | NA | NA |
| 2+ | 308/1790 (17) | 1.02 (0.90 to 1.16) | NA | NA |
| Croup GP contacts (ref=none) | ||||
| 1 | 884/5247 (17) | 0.98 (0.91 to 1.06) | NA | NA |
| 2+ | 264/1432 (18) | 1.14 (0.99 to 1.31) | NA | NA |
| Townsend deprivation quintile | ||||
| 1—least (ref) | 1517/15 285 (10) | ref | Ref | Ref |
| 2 | 2271/16 620 (14) | 1.27 (1.18 to 1.37) | 1.16 (1.07 to 1.25) | 1.16 (1.07 to 1.25) |
| 3 | 2944/17 316 (17) | 1.53 (1.42 to 1.65) | 1.28 (1.18 to 1.38) | 1.28 (1.18 to 1.38) |
| 4 | 3494/17 827 (20) | 1.84 (1.71 to 1.98) | 1.42 (1.32 to 1.54) | 1.42 (1.32 to 1.54) |
| 5—most | 4668/18 602 (25) | 2.32 (2.16 to 2.49) | 1.54 (1.42 to 1.67) | 1.54 (1.42 to 1.67) |
*Adjusted for all variables in the table significant at the 5% level in unadjusted analyses, sex, gestation at birth, small for gestational age (<10th centile), parity, major or minor congenital anomalies, maternal age (25–29 years, <18, 18–24, 30–34, 35+), breast feeding at birth or 6–8 weeks, maternal smoking in first trimester, free school meals in school year take KS1 assessment (to approximate deprivation beyond birth), academic season of birth (autumn, spring, summer), school moves from start school to KS1 (1+), urban or rural (inc. town) dwelling at birth, year take Key Stage 1 (ref 2010).
†Excludes first admission if before first GP visit.
‡Lower respiratory tract infection.
§Includes bronchiolitis if coded with bronchitis.
¶Upper respiratory tract infection.
GP, general practice; LRTI, lower respiratory tract infection.