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Arch Pediatr Adolesc Med. 2004;158:291.

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In reply

I very much appreciate the comments of Dr Stuart, in particular because this is precisely the kind of dialogue I hope to encourage in the clinical community. For any chronic condition associated with a subjective constellation of symptoms and clinical findings (of which asthma is only one example), perceptions of prevalence and race and class disparities are embedded within the cultural, social, and economic experiences of both parents and clinicians. Our current epidemiological picture of asthma, which is based almost entirely on surveys of parental reports, is therefore confounded by these phenomena, which Dr Stuart points out.

I will take the opportunity to clarify one of the findings¹ to which Dr Stuart refers. Dr Stuart interprets the results (likely those reported in Table 3) to mean that " . . . parental reports may underestimate the prevalence of serious asthma among poor children. . . ." It is . . . [Full Text of this Article]

Eric M. Roberts, MD, PhD
California Department of Health Services
1515 Clay St, Suite 1700
Oakland, CA 94612
(e-mail: erobert1@dhs.ca.gov)

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Arch Pediatr Adolesc Med. 2004;158(3):291.
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