Τίτλος:
Detection of exacerbations in asthma based on electronic diary data: Results from the 1-year prospective BIOAIR study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background Objective measures are required that may be used as a proxy for exacerbations in asthma. The aim was to determine the sensitivity and specificity of electronic diary data to detect severe exacerbations (SEs) of asthma. A secondary aim was to identify phenotypic variables associated with a higher risk of exacerbation. Methods In the BIOAIR study, 169 patients with asthma (93 severe (SA); 76 mild to moderate (MA)) recorded lung function, symptoms and medication use in electronic diaries for 1 year. Data were analysed using receiver-operator characteristics curves and related to physician-diagnosed exacerbations. Medical history and baseline clinical data were used to assess risk of exacerbation. Results Of 122 physician-diagnosed exacerbations, 104 occurred in the SA group (1.1 per patient/year), 18 in the MA group (0.2 per patient/year) and 63 were severe using American Thoracic Society/European Respiratory Society criteria. During exacerbations, peak expiratory flow (PEF) and forced expiratory volume in 1 s significantly decreased, whereas day and night symptoms significantly increased. An algorithm combining a 20% decrease in PEF or a 20% increase in day symptoms on 2 consecutive days was able to detect SEs with 65% sensitivity and 95% specificity. The strongest risk factors for SEs were low Asthma Control Questionnaire score, sputum eosinophils ≥3%, body mass index >25 and low quality of life (St George's Respiratory Questionnaire), with ORs between 3.61 and 2.22 ( p<0.05). Conclusions Regular electronic monitoring of PEF and asthma symptoms provides an acceptable sensitivity and specificity for the detection of SEs and may be suitable for personal internet-based monitoring of asthma control.
Συγγραφείς:
Kupczyk, M.
Haque, S.
Sterk, P.J.
Nizankowska-Mogilnicka, E.
Papi, A.
Bel, E.H.
Chanez, P.
Dahlén, B.
Gaga, M.
Gjomarkaj, M.
Howarth, P.H.
Johnston, S.L.
Joos, G.F.
Kanniess, F.
Tzortzaki, E.
James, A.
Middelveld, R.J.M.
Dahlén, S.-E.
Λέξεις-κλειδιά:
beta adrenergic receptor stimulating agent; short acting drug, adult; aged; article; asthma; Asthma Control Questionnaire; body mass; controlled study; data analysis; disease classification; disease control; disease exacerbation; disease severity; drug use; electronic medical record; eosinophil; female; forced expiratory volume; human; Internet; lung function; major clinical study; male; medical history; patient monitoring; peak expiratory flow; phenotype; priority journal; prospective study; quality of life; questionnaire; risk assessment; sensitivity and specificity; sputum analysis; St. George Respiratory Questionnaire; symptom, Asthma; Asthma Guidelines; Respiratory Measurement, Administration, Inhalation; Adolescent; Adult; Aged; Asthma; Bronchodilator Agents; Budesonide; Cross-Over Studies; Disease Progression; Drug Therapy, Combination; Electronic Health Records; Female; Follow-Up Studies; Forced Expiratory Volume; Glucocorticoids; Humans; Male; Middle Aged; Peak Expiratory Flow Rate; Prognosis; Prospective Studies; Quality of Life; Questionnaires; Sensitivity and Specificity; Time Factors; Young Adult
DOI:
10.1136/thoraxjnl-2012-201815
