TY - JOUR
T1 - Detection of exacerbations in asthma based on electronic diary data: Results from the 1-year prospective BIOAIR study
AU - Papadopoulos, Nikolaos
AU - Kupczyk, MacIej
AU - Haque, Shushila
AU - Sterk, Peter J.
AU - Nizankowska-Mogilnicka, Ewa
AU - Papi, Alberto
AU - Bel, Elisabeth H.
AU - Chanez, Pascal
AU - Dahlén, Barbro
AU - Gaga, Mina
AU - Gjomarkaj, Mark
AU - Howarth, Peter H.
AU - Johnston, Sebastian L.
AU - Joos, Guy F.
AU - Kanniess, Frank
AU - Tzortzaki, Eleni
AU - James, Anna
AU - Middelveld, Roelinde J M
AU - Dahlén, Sven Erik
N1 - G0800766, Medical Research Council, United Kingdom
PY - 2013/7
Y1 - 2013/7
N2 - 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
AB - 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
KW - Asthma
KW - Asthma Guidelines
KW - Respiratory Measurement
U2 - 10.1136/thoraxjnl-2012-201815
DO - 10.1136/thoraxjnl-2012-201815
M3 - Article
C2 - 23564399
SN - 0040-6376
VL - 68
SP - 611
EP - 618
JO - Thorax
JF - Thorax
IS - 7
ER -
