Accéder directement au contenu Accéder directement à la navigation
Article dans une revue

Adult Asthma Scores—Development and Validation of Multivariable Scores to Identify Asthma in Surveys

Abstract : BACKGROUND: One of the questions in epidemiology is the identification of adult asthma in studies. OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Liste complète des métadonnées

https://hal.umontpellier.fr/hal-02553170
Contributeur : Amandine Michel-Avella <>
Soumis le : vendredi 24 avril 2020 - 10:54:46
Dernière modification le : vendredi 15 mai 2020 - 12:22:09

Lien texte intégral

Identifiants

Collections

Citation

Ana Sá-Sousa, Ana Margarida Pereira, Rute Almeida, Luís Araújo, Mariana Couto, et al.. Adult Asthma Scores—Development and Validation of Multivariable Scores to Identify Asthma in Surveys. Journal of Allergy and Clinical Immunology: In Practice, Elsevier, 2019, 7 (1), pp.183-190.e6. ⟨10.1016/j.jaip.2018.06.024⟩. ⟨hal-02553170⟩

Partager

Métriques

Consultations de la notice

12