[en] [en] RATIONALE: It is unclear how each individual asthma symptom is associated with asthma diagnosis or control.
OBJECTIVES: To assess the performance of individual asthma symptoms in the identification of patients with asthma and their association with asthma control.
METHODS: In this cross-sectional study, we assessed real-world data using the MASK-air® app. We compared the frequency of occurrence of five asthma symptoms (dyspnea, wheezing, chest tightness, fatigue and night symptoms, as assessed by the Control of Allergic Rhinitis and Asthma Test [CARAT] questionnaire) in patients with probable, possible or no current asthma. We calculated the sensitivity, specificity and predictive values of each symptom, and assessed the association between each symptom and asthma control (measured using the e-DASTHMA score). Results were validated in a sample of patients with a physician-established diagnosis of asthma.
MEASUREMENT AND MAIN RESULTS: We included 951 patients (2153 CARAT assessments), with 468 having probable asthma, 166 possible asthma and 317 no evidence of asthma. Wheezing displayed the highest specificity (90.5%) and positive predictive value (90.8%). In patients with probable asthma, dyspnea and chest tightness were more strongly associated with asthma control than other symptoms. Dyspnea was the symptom with the highest sensitivity (76.1%) and the one consistently associated with the control of asthma as assessed by e-DASTHMA. Consistent results were observed when assessing patients with a physician-made diagnosis of asthma.
CONCLUSIONS: Wheezing and chest tightness were the asthma symptoms with the highest specificity for asthma diagnosis, while dyspnea displayed the highest sensitivity and strongest association with asthma control.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Sousa-Pinto, Bernardo; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; Faculty of Medicine, CINTESIS@RISE - Health Research Network, University of Porto, Porto, Portugal
Louis, Gilles ; Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
Vieira, Rafael J ; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; Faculty of Medicine, CINTESIS@RISE - Health Research Network, University of Porto, Porto, Portugal
Czarlewski, Wienczyslawa; Medical Consulting Czarlewski, Levallois, France ; MASK-air, Montpellier, France
Anto, Josep M; ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
Amaral, Rita; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; Faculty of Medicine, CINTESIS@RISE - Health Research Network, University of Porto, Porto, Portugal
Sá-Sousa, Ana; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; Faculty of Medicine, CINTESIS@RISE - Health Research Network, University of Porto, Porto, Portugal
Brussino, Luisa; Department of Medical Sciences, University of Torino, Torino, Italy ; Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy
Canonica, G Walter; Department of Biomedical Sciences, Humanitas University, Milan, Italy ; Asthma and Allergy Unit, IRCCS Humanitas Research Hospital, Milan, Italy
Loureiro, Claudia Chaves; Department of Pneumology, Faculty of Medicine, Coimbra University Hospital, Coimbra, Portugal ; Coimbra Institute for Clinical and Biomedical Research, CIBB, Coimbra, Portugal
Cruz, Alvaro A; Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
Gemicioglu, Bilun; Department of Pulmonary Diseases, Faculty of Medicine, Istanbul University-Cerrahpaşa, Cerrahpaşa, Istanbul, Turkey ; Institute of Pulmonology and Tuberculosis, Istanbul University-Cerrahpaşa, Istanbul, Turkey
Haahtela, Tari; Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Kupczyk, Maciej; Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
Kvedariene, Violeta; Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Department of Pathology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
Larenas-Linnemann, Desirée E ; Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
Pham-Thi, Nhân; Ecole Polytechnique de Palaiseau, Palaiseau, France ; IRBA (Institut de Recherche Bio-Médicale des Armées), Brétigny sur Orge, France ; Université Paris Cité, Paris, France
Puggioni, Francesca; IRCCS Humanitas Research Center, Personalized Medicine Asthma & Allergy, Rozzano, Milan, Italy
Regateiro, Frederico S; Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal ; Faculty of Medicine, Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal ; Faculty of Medicine, Institute of Immunology, University of Coimbra, Coimbra, Portugal ; UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
Romantowski, Jan; Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
Sastre, Joaquin; Allergy Service, Fundacion Jimenez Diaz, Autonoma University of Madrid, CIBERES-ISCIII, Madrid, Spain
Scichilone, Nicola; PROMISE Department, University of Palermo, Palermo, Italy
Taborda-Barata, Luis; UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal ; Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
Ventura, Maria Teresa ; Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy ; Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
Agache, Ioana; Faculty of Medicine, Transylvania University Brasov, Brasov, Romania
Bedbrook, Anna; MASK-air, Montpellier, France ; ARIA, Montpellier, France
Benfante, Alida; PROMISE Department, University of Palermo, Palermo, Italy
Bergmann, Karl C; Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany ; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
Bosnic-Anticevich, Sinthia; Quality Use of Respiratory Medicines Group, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia ; Macquarie Medical School, Macquarie University, Macquarie Park, New South Wales, Australia
Bonini, Matteo; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy ; National Heart and Lung Institute (NHLI), Imperial College London, London, UK
Boulet, Louis-Philippe; Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
Brusselle, Guy; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
Buhl, Roland; Department of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany
Cecchi, Lorenzo; SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
Charpin, Denis; Clinique des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France
Costa, Elisio M; CINTESIS@RISE, Biochemistry Lab, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto, Porto, Portugal
Del Giacco, Stefano; Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
Jutel, Marek; Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland ; ALL-MED Medical Research Institute, Wroclaw, Poland
Klimek, Ludger; Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany ; Center for Rhinology and Allergology, Wiesbaden, Germany
Kuna, Piotr; Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
Laune, Daniel; KYomed INNOV, Montpellier, France
Makela, Mika; Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Morais-Almeida, Mario; Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
Nadif, Rachel; Université Paris-Saclay, UVSQ, University Paris-Sud, Villejuif, France ; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
Niedoszytko, Marek; UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal ; Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
Papadopoulos, Nikolaos G; Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
Papi, Alberto ; Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
Pfaar, Oliver ; Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
Rivero-Yeverino, Daniela; Servicio de Alergia e Inmunología clínica, Hospital Universitario de Puebla, Puebla, México
Roche, Nicolas; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France ; Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France ; UMR 1016, Institut Cochin, Paris, France
Samolinski, Boleslaw; Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
Shamji, Mohamed H ; National Heart and Lung Institute (NHLI), Imperial College London, London, UK ; NIHR Imperial Biomedical Research Centre, London, UK
Sheikh, Aziz; Usher Institute, The University of Edinburgh, Edinburgh, UK
Ulrik, Charlotte Suppli; Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark ; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Usmani, Omar S; National Heart and Lung Institute (NHLI), Imperial College London, London, UK ; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ; Airways Disease Section, Royal Brompton Hospital, London, UK
Valiulis, Arunas; Interdisciplinary Research Group of Human Ecology, Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania ; European Academy of Paediatrics (EAP/UEMS-SP), Brussel, Belgium
Yorgancioglu, Arzu; Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
Zuberbier, Torsten ; Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany ; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
Fonseca, Joao A; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal ; Faculty of Medicine, CINTESIS@RISE - Health Research Network, University of Porto, Porto, Portugal
Pétré, Benoît ; Université de Liège - ULiège > Département des sciences de la santé publique > Education thérapeutique du patient au service des soins intégrés
Louis, Renaud ; Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
Bousquet, Jean ; MASK-air, Montpellier, France ; ARIA, Montpellier, France ; Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany ; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany ; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
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