Validation of the adult asthma epidemiological score: a secondary analysis of the EPI-ASTHMA population-based study.

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Cristina Isabel Oliveira Jácome

    Autor

  • Rita Da Silva Amaral

    Autor

  • João De Almeida Lopes Da Fonseca

    Autor

Participantes de fora da FMUP

  • Laranjeira C
  • Bernardo F
  • Correia-de-Sousa J

Unidades de investigação

Abstract

OBJECTIVE: The A2 score is an eight-question patient-reported outcome measure that has been validated for ruling in (score =4) and ruling out (score 0-1) asthma. However, this screening tool has been validated in a cohort similar to the derivation cohort used. This study aims to validate the predictive accuracy of the A2 score in a primary care population against general practitioner (GP) clinical assessment and to determine whether the proposed cut-offs are the most appropriate. DESIGN: This accuracy study is a secondary analysis of the EPI-ASTHMA population-based study. SETTING: Primary care centres in Portugal. PARTICIPANTS: Random adult participants answered the A2 score by phone interview. OUTCOMES: Those with an A2 score =1 (plus 5% with an A2 score of 0) were invited to a diagnostic visit carried out by a GP to confirm or not a diagnosis of asthma. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves. RESULTS: A total of 1283 participants (median 54 (p25-p75 43-66) years; 60% women) were analysed. The A2 score showed high discriminatory power in identifying asthma, with an area under the ROC curve of 82.9% (95% CI 80.4% to 85.4%). The proposed cut-off =4 was the most appropriate to rule in asthma (specificity 83.1%, positive predictive value 62.4%, accuracy 78%). Similarly, the proposed cut-off<2 was the most suitable for excluding asthma (sensitivity 92.7%, negative predictive value 93.7%, accuracy 60.5%). CONCLUSIONS: The A2 score is a useful tool to identify patients with asthma in a primary care population. TRIAL REGISTRATION NUMBER: NCT0516961.

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Dados da publicação

ISSN/ISSNe:
2044-6055, 2044-6055

BMJ Open  BMJ Publishing Group

Tipo:
Article
Páginas:
-
Link para outro recurso:
www.scopus.com

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Keywords

  • Asthma; Epidemiology; Patient Reported Outcome Measures

Proyectos asociados

Prevalence and Characterisation of Asthma Patients According to Disease Severity in Portugal (EPI-ASTHMA) - NCT05169619

Investigador Principal: João de Almeida Lopes da Fonseca

Estudo Clínico Observacional (EPI-ASTHMA) . AstraZeneca . 2021

Effect of a Mobile App on Improving Asthma Control in Adolescents and Adults With Persistent Asthma: A Pilot Randomized Multicentre, Superiority Clinical Trial (mINSPIRERS) - NCT05129527

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Ensaio Clínico Académico (mINSPIRERS) . 2021

Utilização em estudos observacionais do Registo de Asma Grave Portugal.

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Estudo Observacional Académico (RAG) . 2020

Clinical Research Collaboration Severe Heterogenous Asthma Research collaboration, Patient-centered (CRC SHARP).

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Estudo Clínico Observacional (SHARP) . European Respiratory Society . 2021

Multidimensional phenotyping of severe asthma patients and its impact on disease control and therapeutic response - analysis from the Portuguese Severe Asthma Registry.

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Estudo Clínico Observacional (RAG-SPP-GSK) . SPPneumologia . 2022

BREATHE - An oBservational, pRimary data study to characterize severe AsThma pHenotypes and assEss disease burden across the EUCAN region.

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Estudo Clínico Observacional (RAG-AZ-BREATHE) . AstraZeneca . 2022

Measuring adherence to inhaled control medication in patients with asthma: comparison among an asthma app, patient self-report and physician assessment.

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Estudo Clínico Académico . 2023

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Use of secondary data, health technology assessment methods and economic modelling applied to penicillin allergy

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Using different data sources for the identification of asthma patients and those at high risk of adverse outcomes

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Estudo Clínico Académico . 2020

Phenotypes of Chronic Diseases of the Airways: Towards Multidimensional Data -Driven Profiling

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Estudo Clínico Académico . 2020

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