Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.22/13997 |
Resumo: | One of the questions in epidemiology is the identification of adult asthma in studies. To develop and validate multivariable scores for adult asthma identification in epidemiological studies and to explore cutoffs to rule in/rule out asthma, compared with asthma diagnosed by a physician after clinical examination and diagnostic tests, blinded to the self-administered questions. We analyzed data (n = 711 adults) from a nationwide population-based study. The predictors were self-administered questions identified in a literature review (the Adult Asthma Epidemiological Score [A2 score]) and from the Global Allergy and Asthma Network of Excellence (GA2LEN) questionnaire (the GA2LEN Asthma Epidemiological Score [GA2LEN score]). Scores were developed using exploratory factor analysis. Internal consistency, discriminative power, and diagnostic accuracy were assessed. The A2 score comprises 8 questions (including “Did a physician confirm you had asthma?”) and the GA2LEN score comprises 6 questions (including “Have you ever had asthma?”). Both had high Cronbach α (0.89 and 0.85, respectively, for the A2 score and the GA2LEN score) and good area under the receiver-operating characteristic curve (90.4% and 89.0%). The scoring is the sum of positive answers. Asthma is present (rule in) for scores of 4 or more (specificity, 99.2%; PPV, 93.3% and 91.7%; accuracy, 89.4% and 87.4%, respectively, for the A2 score and the GA2LEN score). Asthma is excluded (rule out) for A2 scores of 0 to 1 and a GA2LEN score of 0 (sensitivity, 93.1%; NPV, 98.2% and 98.0%; accuracy 89.4% and 82.8%, respectively, for the A2 score and the GA2LEN score). These practical scores can be used to rule in/rule out asthma in epidemiological studies and clinical screening/triage settings. They may help physicians in primary care or other specialties to screen patients with asthma using a simple score with a high level of discrimination and to identify the best candidates to be referred for a diagnostic workup. Moreover, their use may contribute to reducing the inconsistencies of operational definitions of asthma across studies and surveys. |
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Adult asthma scores—development and validation of multivariable scores to identify asthma in surveysAsthmaEpidemiologyValidation studiesFactor analysisQuestionnaire surveyOne of the questions in epidemiology is the identification of adult asthma in studies. To develop and validate multivariable scores for adult asthma identification in epidemiological studies and to explore cutoffs to rule in/rule out asthma, compared with asthma diagnosed by a physician after clinical examination and diagnostic tests, blinded to the self-administered questions. We analyzed data (n = 711 adults) from a nationwide population-based study. The predictors were self-administered questions identified in a literature review (the Adult Asthma Epidemiological Score [A2 score]) and from the Global Allergy and Asthma Network of Excellence (GA2LEN) questionnaire (the GA2LEN Asthma Epidemiological Score [GA2LEN score]). Scores were developed using exploratory factor analysis. Internal consistency, discriminative power, and diagnostic accuracy were assessed. The A2 score comprises 8 questions (including “Did a physician confirm you had asthma?”) and the GA2LEN score comprises 6 questions (including “Have you ever had asthma?”). Both had high Cronbach α (0.89 and 0.85, respectively, for the A2 score and the GA2LEN score) and good area under the receiver-operating characteristic curve (90.4% and 89.0%). The scoring is the sum of positive answers. Asthma is present (rule in) for scores of 4 or more (specificity, 99.2%; PPV, 93.3% and 91.7%; accuracy, 89.4% and 87.4%, respectively, for the A2 score and the GA2LEN score). Asthma is excluded (rule out) for A2 scores of 0 to 1 and a GA2LEN score of 0 (sensitivity, 93.1%; NPV, 98.2% and 98.0%; accuracy 89.4% and 82.8%, respectively, for the A2 score and the GA2LEN score). These practical scores can be used to rule in/rule out asthma in epidemiological studies and clinical screening/triage settings. They may help physicians in primary care or other specialties to screen patients with asthma using a simple score with a high level of discrimination and to identify the best candidates to be referred for a diagnostic workup. Moreover, their use may contribute to reducing the inconsistencies of operational definitions of asthma across studies and surveys.ElsevierRepositório Científico do Instituto Politécnico do PortoSá-Sousa, AnaPereira, Ana MargaridaAlmeida, RuteAraújo, LuísCouto, MarianaJacinto, TiagoFreitas, AlbertoBousquet, JeanFonseca, João A.2020-02-02T01:30:31Z2019-012019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.22/13997engSá-Sousa, A., Pereira, A. M., Almeida, R., Araújo, L., Couto, M., Jacinto, T., Freitas, A., Bousquet, J., & Fonseca, J. A. (2019). Adult Asthma Scores—Development and Validation of Multivariable Scores to Identify Asthma in Surveys. The Journal of Allergy and Clinical Immunology: In Practice, 7(1), 183-190.e6. https://doi.org/10.1016/j.jaip.2018.06.02410.1016/j.jaip.2018.06.024info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-12-20T01:53:26Zoai:recipp.ipp.pt:10400.22/13997Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:33:50.887310Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys |
title |
Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys |
spellingShingle |
Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys Sá-Sousa, Ana Asthma Epidemiology Validation studies Factor analysis Questionnaire survey |
title_short |
Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys |
title_full |
Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys |
title_fullStr |
Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys |
title_full_unstemmed |
Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys |
title_sort |
Adult asthma scores—development and validation of multivariable scores to identify asthma in surveys |
author |
Sá-Sousa, Ana |
author_facet |
Sá-Sousa, Ana Pereira, Ana Margarida Almeida, Rute Araújo, Luís Couto, Mariana Jacinto, Tiago Freitas, Alberto Bousquet, Jean Fonseca, João A. |
author_role |
author |
author2 |
Pereira, Ana Margarida Almeida, Rute Araújo, Luís Couto, Mariana Jacinto, Tiago Freitas, Alberto Bousquet, Jean Fonseca, João A. |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Instituto Politécnico do Porto |
dc.contributor.author.fl_str_mv |
Sá-Sousa, Ana Pereira, Ana Margarida Almeida, Rute Araújo, Luís Couto, Mariana Jacinto, Tiago Freitas, Alberto Bousquet, Jean Fonseca, João A. |
dc.subject.por.fl_str_mv |
Asthma Epidemiology Validation studies Factor analysis Questionnaire survey |
topic |
Asthma Epidemiology Validation studies Factor analysis Questionnaire survey |
description |
One of the questions in epidemiology is the identification of adult asthma in studies. To develop and validate multivariable scores for adult asthma identification in epidemiological studies and to explore cutoffs to rule in/rule out asthma, compared with asthma diagnosed by a physician after clinical examination and diagnostic tests, blinded to the self-administered questions. We analyzed data (n = 711 adults) from a nationwide population-based study. The predictors were self-administered questions identified in a literature review (the Adult Asthma Epidemiological Score [A2 score]) and from the Global Allergy and Asthma Network of Excellence (GA2LEN) questionnaire (the GA2LEN Asthma Epidemiological Score [GA2LEN score]). Scores were developed using exploratory factor analysis. Internal consistency, discriminative power, and diagnostic accuracy were assessed. The A2 score comprises 8 questions (including “Did a physician confirm you had asthma?”) and the GA2LEN score comprises 6 questions (including “Have you ever had asthma?”). Both had high Cronbach α (0.89 and 0.85, respectively, for the A2 score and the GA2LEN score) and good area under the receiver-operating characteristic curve (90.4% and 89.0%). The scoring is the sum of positive answers. Asthma is present (rule in) for scores of 4 or more (specificity, 99.2%; PPV, 93.3% and 91.7%; accuracy, 89.4% and 87.4%, respectively, for the A2 score and the GA2LEN score). Asthma is excluded (rule out) for A2 scores of 0 to 1 and a GA2LEN score of 0 (sensitivity, 93.1%; NPV, 98.2% and 98.0%; accuracy 89.4% and 82.8%, respectively, for the A2 score and the GA2LEN score). These practical scores can be used to rule in/rule out asthma in epidemiological studies and clinical screening/triage settings. They may help physicians in primary care or other specialties to screen patients with asthma using a simple score with a high level of discrimination and to identify the best candidates to be referred for a diagnostic workup. Moreover, their use may contribute to reducing the inconsistencies of operational definitions of asthma across studies and surveys. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-01 2019-01-01T00:00:00Z 2020-02-02T01:30:31Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.22/13997 |
url |
http://hdl.handle.net/10400.22/13997 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Sá-Sousa, A., Pereira, A. M., Almeida, R., Araújo, L., Couto, M., Jacinto, T., Freitas, A., Bousquet, J., & Fonseca, J. A. (2019). Adult Asthma Scores—Development and Validation of Multivariable Scores to Identify Asthma in Surveys. The Journal of Allergy and Clinical Immunology: In Practice, 7(1), 183-190.e6. https://doi.org/10.1016/j.jaip.2018.06.024 10.1016/j.jaip.2018.06.024 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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