Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Bernardo Manuel De Sousa Pinto

    Autor

  • Cristina Isabel Oliveira Jácome

    Autor

  • Ana Margarida Barbosa Ribeiro Pereira

    Autor

  • Rute Alexandra Borges De Almeida

    Autor

  • Rafael José Monteiro Da Silva Vieira

    Autor

  • Rita Da Silva Amaral

    Autor

  • Luís Filipe Ribeiro De Azevedo

    Autor

  • Ana Isabel Alves De Sá E Sousa

    Autor

  • Pedro Manuel Vieira Marques

    Autor

  • João De Almeida Lopes Da Fonseca

    Autor

Participantes de fora da FMUP

  • Regateiro, FS
  • Czarlewski, W
  • Kulus, M
  • Shamji, MH
  • Boulet, LP
  • Bonini, M
  • Brussino, L
  • Canonica, GW
  • Cruz, AA
  • Gemicioglu, B
  • Haahtela, T
  • Kupczyk, M
  • Kvedariene, V
  • Larenas-Linnemann, D
  • Louis, R
  • Niedoszytko, M
  • Nhan, PT
  • Puggioni, F
  • Romantowski, J
  • Sastre, J
  • Scichilone, N
  • Taborda Barata, L
  • Ventura, MT
  • Agache, I
  • Bedbrook, A
  • Bergmann, KC
  • Bosnic Anticevich, S
  • Brusselle, G
  • Buhl, R
  • Cecchi, L
  • Charpin, D
  • Loureiro, CC
  • de Blay, F
  • Del Giacco, S
  • Devillier, P
  • Jassem, E
  • Joos, G
  • Jutel, M
  • Klimek, L
  • Kuna, P
  • Laune, D
  • Pech, JL
  • Makela, M
  • Morais-Almeida, M
  • Nadif, R
  • Neffen, HE
  • Ohta, K
  • Papadopoulos, NG
  • Papi, A
  • Pétré, B
  • Pfaar, O
  • Yeverino, DR
  • Cordeiro, CR
  • Roche, N
  • Samolinski, B
  • Sheikh, A
  • Ulrik, CS
  • Usmani, OS
  • Valiulis, A
  • Vandenplas, O
  • Yorgancioglu, A
  • Zuberbier, T
  • Anto, JM
  • Bousquet, J

Unidades de investigação

Abstract

Background Validated questionnaires are used to assess asthma control over the past 1-4 weeks from reporting. However, they do not adequately capture asthma control in patients with fluctuating symptoms. Using the Mobile Airways Sentinel Network for airway diseases (MASK-air) app, we developed and validated an electronic daily asthma control score (e-DASTHMA). Methods We used MASK-air data (freely available to users in 27 countries) to develop and assess different daily control scores for asthma. Data-driven control scores were developed based on asthma symptoms reported by a visual analogue scale (VAS) and self-reported asthma medication use. We included the daily monitoring data from all MASK-air users aged 16-90 years (or older than 13 years to 90 years in countries with a lower age of digital consent) who had used the app in at least 3 different calendar months and had reported at least 1 day of asthma medication use. For each score, we assessed construct validity, test-retest reliability, responsiveness, and accuracy. We used VASs on dyspnoea and work disturbance, EQ-5D-VAS, Control of Allergic Rhinitis and Asthma Test (CARAT), CARAT asthma, and Work Productivity and Activity Impairment: Allergy Specific (WPAI:AS) questionnaires as comparators. We performed an internal validation using MASK-air data from Jan 1 to Oct 12, 2022, and an external validation using a cohort of patients with physician-diagnosed asthma (the INSPIRERS cohort) who had had their diagnosis and control (Global Initiative for Asthma [GINA] classification) of asthma ascertained by a physician. Findings We studied 135 635 days of MASK-air data from 1662 users from May 21, 2015, to Dec 31, 2021. The scores were strongly correlated with VAS dyspnoea (Spearman correlation coefficient range 0.68-0.82) and moderately correlated with work comparators and quality-of-life-related comparators (for WPAI:AS work, we observed Spearman correlation coefficients of 0.59-0.68). They also displayed high test-retest reliability (intraclass correlation coefficients range 0.79-0.95) and moderate-to-high responsiveness (correlation coefficient range 0.69-0.79; effect size measures range 0.57-0.99 in the comparison with VAS dyspnoea). The best-performing score displayed a strong correlation with the effect of asthma on work and school activities in the INSPIRERS cohort (Spearman correlation coefficients 0.70; 95% CI 0.61-0.78) and good accuracy for the identification of patients with uncontrolled or partly controlled asthma according to GINA (area under the receiver operating curve 0.73; 95% CI 0.68-0.78). Interpretation e-DASTHMA is a good tool for the daily assessment of asthma control. This tool can be used as an endpoint in clinical trials as well as in clinical practice to assess fluctuations in asthma control and guide treatment optimisation. Funding None. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.

Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Dados da publicação

ISSN/ISSNe:
2589-7500, 2589-7500

LANCET DIGITAL HEALTH  Elsevier Ltd.

Tipo:
Article
Páginas:
227-238
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 2

Citações Recebidas na Scopus: 19

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Keywords

  • RESPONSIVENESS; QUESTIONNAIRE; RELIABILITY; INSTRUMENTS; RHINITIS

Financiamento

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