Methods of measuring asthma severity and influence on patient assignment

Lee, Susanna; Kirking, Duane M.; Erickson, Steven R.

doi:10.1016/s1081-1206(10)61512-8

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…This level of concordance is consistent with other studies, which show severity ratings differ substantially by method (κ coefficients in the 0.1–0.3 range). 28 For example, agreement between clinician raters compared with EPR-2 (weighted κ = 0.2) and GINA (weighted κ = 0.25) in a multicenter trial was of similar magnitude. 29 Among 14 pediatric allergists and pulmonologists using EPR-2 to rate severity, agreement was also poor (κ = 0.29) and even lower when they were asked the main factors used in their assessment (κ = 0.19).…”

Section: Discussionmentioning

confidence: 87%

Conundrums in childhood asthma severity, control, and health care use: Puerto Rico versus Rhode Island

Esteban

Klein

McQuaid

et al. 2009

Journal of Allergy and Clinical Immunology

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Section: Discussionmentioning

confidence: 87%

Conundrums in childhood asthma severity, control, and health care use: Puerto Rico versus Rhode Island

Esteban

Klein

McQuaid

et al. 2009

Journal of Allergy and Clinical Immunology

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“…Schatz et al have shown that SABA prescriptions filled, obtained from a pharmacy database, reflect asthma symptom control over time (13). Lee et al evaluated agreement among patient-perceived, symptom-derived, and medication-derived assessment methods for determining asthma severity (25). Although there was considerable disagreement in asthma severity categorization among the methods used in this study, it was clear that the medicationderived method (similar to the claims-based approach used in this study) categorized patients as having more severe asthma than either the patient-perceived or the symptom-derived methods.…”

Section: Discussionmentioning

confidence: 99%

Asthma Severity Categorization Using a Claims-Based Algorithm or Pulmonary Function Testing

Birnbaum

Ivanova

et al. 2009

Journal of Asthma

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The claims-based algorithm generally categorized patients as having more severe asthma than the approach using pulmonary function test results. Pulmonary function test results would have appreciably changed asthma severity categorization in only a small percent of patients. These findings add further support to the use of administrative database analyses for the evaluation of asthma care in large populations.

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“…[7][8][9][10][11][12] These indexes are usually based on one or several factors that are considered clinically important in the assessment of asthma severity and control such as frequency, duration and intensity of symptoms and pulmonary function tests. However, to the best of our knowledge, none of these indexes relies solely on data usually recorded in administrative health databases.…”

mentioning

confidence: 99%

Development and validation of database indexes of asthma severity and control

Firoozi

Lemière

Beauchesne

et al. 2007

Thorax

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Background: The use of administrative databases to perform epidemiological studies in asthma has increased in recent years. The absence of clinical parameters to measure the level of asthma severity and control is a major limitation of database studies. A study was undertaken to develop and validate two database indexes to measure the control and severity of asthma. Methods: Database indexes of asthma severity and control were derived from definitions in the Canadian Asthma Consensus Guidelines based on dispensed prescriptions and on medical services recorded in two large administrative databases from the Canadian province of Québec (Régie de l'Assurance Maladie du Québec (RAMQ) and MED-ECHO) over 12 months. The database indexes of asthma severity and control were validated against the pulmonary function test results of 71 patients with asthma randomly selected from two asthma clinics, and they were also applied to a cohort of patients with asthma followed up for 139 283 person-years selected from the RAMQ and MED-ECHO databases between 1 January 1997 and 31 December 2004. Results: According to the database indexes, 49.3%, 29.6% and 21.1% of patients recruited at the asthma clinics were found to have mild, moderate and severe asthma, respectively, while 53.5% were found to have controlled asthma. The mean predicted value of the forced expiratory volume in 1 s (FEV 1 ) ranged from 89.8% for mild asthma to 61.5% for severe asthma (p,0.001), whereas the range from controlled to uncontrolled asthma was 89.5% to 67.3% (p,0.001). The ratio of the FEV 1 to the forced vital capacity (FEV 1 / FVC ratio) measured in 56 patients ranged from 75.8% for mild asthma to 61.8% for severe asthma (p = 0.030), whereas the range from controlled to uncontrolled asthma was 75.3% to 65.7% (p,0.001). Conclusion: In the absence of clinical data, these database indexes could be used in epidemiological studies to assess the severity and control of asthma.

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Methods of measuring asthma severity and influence on patient assignment

Cited by 7 publications

References 15 publications

Conundrums in childhood asthma severity, control, and health care use: Puerto Rico versus Rhode Island

Conundrums in childhood asthma severity, control, and health care use: Puerto Rico versus Rhode Island

Asthma Severity Categorization Using a Claims-Based Algorithm or Pulmonary Function Testing

Development and validation of database indexes of asthma severity and control

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