Kevin R Murphy1, Bradley Chipps2, David A Beuther3, Robert A Wise4, William McCann5, Ileen Gilbert6, James M Eudicone6, Hitesh N Gandhi6, Gale Harding7, Karin S Coyne7, Robert S Zeiger8. 1. Boys Town National Research Hospital, Boys Town, Neb. Electronic address: kevin.murphy@boystown.org. 2. Capital Allergy & Respiratory Disease Center, Sacramento, Calif. 3. Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colo. 4. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. 5. Allergy Partners, Asheville, NC. 6. AstraZeneca, Wilmington, Del. 7. Evidera, Bethesda, Md. 8. Departments of Allergy and Research and Evaluation, Kaiser Permanente Southern California, San Diego and Pasadena, Calif.
Abstract
BACKGROUND: Asthma exacerbation risk increases with worsening asthma control. Prevailing numerical control tools evaluate only current symptom impairment despite the importance of also assessing risk based on exacerbation history. An easy-to-use questionnaire addressing impairment and risk domains of control is needed. OBJECTIVE: To validate a composite asthma control tool that includes impairment and risk assessments (Asthma Impairment and Risk Questionnaire [AIRQ]). METHODS: Four-hundred forty-two patients aged ≥12 years with physician-diagnosed asthma who were followed in specialty practices completed 15 impairment and risk questions with dichotomized yes/no responses. Patients spanned all Global Initiative for Asthma severities and were classified as well-controlled, not well-controlled, or very poorly controlled according to a standard of Asthma Control Test (ACT) score plus prior-year exacerbations. Logistic regression analyses identified questions with the greatest predictive validity to discriminate among patients and determine cut points for these 3 classifications. RESULTS: The final AIRQ comprises 10 equally weighted yes/no impairment and risk questions. The final 10-item models yielded receiver operating characteristic curves of 0.94 to identify well-controlled versus not well-/very poorly controlled and 0.93 to identify well-/not well-controlled versus very poorly controlled asthma, as reflected by the ACT plus prior-year exacerbations standard. Cut points of 0-1, 2-4, and 5-10 best represented well-, not well-, and very poorly controlled asthma. CONCLUSIONS: AIRQ is a rigorously validated composite measure designed to identify adults and adolescents with varying degrees of asthma control. Ongoing investigations will determine test-retest reliability, responsiveness to change, and predictive ability for future exacerbations.
BACKGROUND:Asthma exacerbation risk increases with worsening asthma control. Prevailing numerical control tools evaluate only current symptom impairment despite the importance of also assessing risk based on exacerbation history. An easy-to-use questionnaire addressing impairment and risk domains of control is needed. OBJECTIVE: To validate a composite asthma control tool that includes impairment and risk assessments (Asthma Impairment and Risk Questionnaire [AIRQ]). METHODS: Four-hundred forty-two patients aged ≥12 years with physician-diagnosed asthma who were followed in specialty practices completed 15 impairment and risk questions with dichotomized yes/no responses. Patients spanned all Global Initiative for Asthma severities and were classified as well-controlled, not well-controlled, or very poorly controlled according to a standard of Asthma Control Test (ACT) score plus prior-year exacerbations. Logistic regression analyses identified questions with the greatest predictive validity to discriminate among patients and determine cut points for these 3 classifications. RESULTS: The final AIRQ comprises 10 equally weighted yes/no impairment and risk questions. The final 10-item models yielded receiver operating characteristic curves of 0.94 to identify well-controlled versus not well-/very poorly controlled and 0.93 to identify well-/not well-controlled versus very poorly controlled asthma, as reflected by the ACT plus prior-year exacerbations standard. Cut points of 0-1, 2-4, and 5-10 best represented well-, not well-, and very poorly controlled asthma. CONCLUSIONS:AIRQ is a rigorously validated composite measure designed to identify adults and adolescents with varying degrees of asthma control. Ongoing investigations will determine test-retest reliability, responsiveness to change, and predictive ability for future exacerbations.
Authors: Andrew Menzies-Gow; Flavia L Hoyte; David B Price; David Cohen; Peter Barker; James Kreindler; Maria Jison; Christopher L Brooks; Peggy Papeleu; Rohit Katial Journal: Adv Ther Date: 2022-03-14 Impact factor: 4.070