[en] [en] BACKGROUND: In clinical and epidemiological studies, cutoffs of patient-reported outcome measures can be used to classify patients into groups of statistical and clinical relevance. However, visual analog scale (VAS) cutoffs in MASK-air have not been tested.
OBJECTIVE: To calculate cutoffs for VAS global, nasal, ocular, and asthma symptoms.
METHODS: In a cross-sectional study design of all MASK-air participants, we compared (1) approaches based on the percentiles (tertiles or quartiles) of VAS distributions and (2) data-driven approaches based on clusters of data from 2 comparators (VAS work and VAS sleep). We then performed sensitivity analyses for individual countries and for VAS levels corresponding to full allergy control. Finally, we tested the different approaches using MASK-air real-world cross-sectional and longitudinal data to assess the most relevant cutoffs.
RESULTS: We assessed 395,223 days from 23,201 MASK-air users with self-reported allergic rhinitis. The percentile-oriented approach resulted in lower cutoff values than the data-driven approach. We obtained consistent results in the data-driven approach. Following the latter, the proposed cutoff differentiating "controlled" and "partly-controlled" patients was similar to the cutoff value that had been arbitrarily used (20/100). However, a lower cutoff was obtained to differentiate between "partly-controlled" and "uncontrolled" patients (35 vs the arbitrarily-used value of 50/100).
CONCLUSIONS: Using a data-driven approach, we were able to define cutoff values for MASK-air VASs on allergy and asthma symptoms. This may allow for a better classification of patients with rhinitis and asthma according to different levels of control, supporting improved disease management.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Sousa-Pinto, Bernardo; MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal, 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, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal, RISE-Health Research Network, University of Porto, Porto, Portugal
Vieira, Rafael José; MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal, RISE-Health Research Network, University of Porto, Porto, Portugal
Amaral, Rita; MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal, RISE-Health Research Network, University of Porto, Porto, Portugal
Pereira, Ana Margarida; MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal, RISE-Health Research Network, University of Porto, Porto, Portugal
Anto, Josep M; Department of Research & Development, ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain, Department of Medical Research & Environment, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain, Department of Epidemiology of Asthma, Universitat Pompeu Fabra (UPF), Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
Klimek, Ludger; Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany, Center for Rhinology and Allergology, Wiesbaden, Germany
Czarlewski, Wienczyslawa; Medical Consulting Czarlewski, Levallois and MASK-air, Montpellier, France
Mullol, Joaquim; Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
Pfaar, Oliver; Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
Bedbrook, Anna; Department of Allergy, ARIA & MASK-air, Montpellier, France
Brussino, Luisa; Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino and Mauriziano Hospital, Torino, Italy
Kvedariene, Violeta; Department of Pathology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania, Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, 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
Okamoto, Yoshitaka; Department of Otorhinolaryngology, Chiba University Hospital and Chiba Rosai Hospital, Chiba, Japan
Ventura, Maria Teresa; Unit of Geriatric Immunoallergology, University of Bari Medical School and Institute of Sciences of Food Production, National Research Council (Ispa-Cnr), Bari, Italy
Ansotegui, Ignacio J; Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
Bosnic-Anticevich, Sinthia; Quality Use of Respiratory Medicines Group, Woolcock Institute of Medical Research, Sydney, Sydney Pharmacy School, The University of Sydney, Sydney Local Health District, Sydney, NSW, Australia
Canonica, G Walter; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy, Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
Cardona, Victoria; Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL research network, Barcelona, Spain
Cecchi, Lorenzo; SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
Chivato, Tomas; School of Medicine, University CEU San Pablo, Madrid, Spain
Cingi, Cemal; ENT Department, Eskisehir Osmangazi University, Medical Faculty, Eskisehir, Turkey
Costa, Elísio M; UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
Cruz, Alvaro A; Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
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
Devillier, Philippe; VIM Suresnes, UMR 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
Fokkens, Wytske J; Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
Gemicioglu, Bilun; Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
Haahtela, Tari; Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
Ivancevich, Juan Carlos; Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
Kuna, Piotr; Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
Kaidashev, Igor; Department of Internal Medicine, Poltava State Medical University, Poltava, Ukraine
Kraxner, Helga; Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
Laune, Daniel; Department Recherches & Développement, KYomed INNOV, Montpellier, France
Louis, Renaud ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pneumologie - allergologie
Makris, Michael; Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
Monti, Riccardo; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Morais-Almeida, Mario; Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
Mösges, Ralph; IMSB, Medical Faculty, University at Cologne, and ClinCompetence Cologne GmbH, Cologne, Germany
Niedoszytko, Marek; Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
Papadopoulos, Nikolaos G; Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
Patella, Vincenzo; Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy
Pham-Thi, Nhân; Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
Regateiro, Frederico S; Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal, Coimbra Institute for Clinical and Biomedical Research (ICBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Reitsma, Sietze; Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
Rouadi, Philip W; Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon, Department of Otolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait
Samolinski, Boleslaw; Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Poland
Sheikh, Aziz; Usher Institute, the University of Edinburgh, Edinburgh, UK
Sova, Milan; Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic
Taborda-Barata, Luis; UBIAir-Clinical & Experimental Lung Centre, University of Beira Interior, Covilhã and CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal, Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
Toppila-Salmi, Sanna; Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
Sastre, Joaquin; Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
Tsiligianni, Ioanna; Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece, International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
Valiulis, Arunas; Institute of Clinical Medicine and Institute of Health Sciences, Vilnius, Lithunia, Medical Faculty of Vilnius University, Vilnius, Lithuania
Yorgancioglu, Arzu; Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
Zidarn, Mihaela; University Clinic of Respiratory and Allergic Diseases, Golnik & University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
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, Allergology and Immunology, Berlin, Germany
Fonseca, Joao A; MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal, RISE-Health Research Network, University of Porto, Porto, Portugal
Bousquet, Jean; 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, Allergology and Immunology, Berlin, Germany, Department of Pneumology, University Hospital, Montpellier, France. Electronic address: jean.bousquet@orange.fr
AHA - American Heart Association [US-TX] EU - European Union [BE] Charité - Universitätsmedizin Berlin [DE] EIT Health [DE]
Funding text :
MASK-air has been supported by Charité Universitätsmedizin Berlin , EU grants (EU Structural and Development Funds; POLLAR, EIT Health, Twinning, EIP on AHA and H2020) and educational grants from Mylan-Viatris, ALK, GSK, Novartis , and Uriach.
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