TY - JOUR
T1 - Detection of exacerbations in asthma based on electronic diary data: results from the 1-year prospective BIOAIR study
AU - Kupczyk, Maciej
AU - Haque, Shushila
AU - Sterk, Peter J.
AU - Niżankowska-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
AU - AUTHOR GROUP
AU - Weersink, Els
AU - Papadopoulos, Nikos
AU - Oikonomidou, Erasmia
AU - Zervas, Eleftherios
AU - Contoli, Marco
AU - Pauwels, Romain A.
AU - Brusselle, Guy
AU - de Rudder, Isabelle
AU - Schelfhout, Vanessa
AU - Richter, Kai
AU - Gerding, Daisy
AU - Magnussen, Helgo
AU - Siafakas, Nikos M.
AU - Samara, Katerina
AU - Plataki, Maria
AU - Papadopouli, Eva
AU - Szczeklik, Andrzej
AU - Ziolkowska-Graca, Bozena
AU - Kania, Aleksander
AU - Gawlewicz-Mroczka, Agnieszka
AU - Duplaga, Mariusz
AU - Figiel, Ewa
AU - Rabe, Klaus F.
AU - Hiemstra, Pieter S.
AU - Gauw, Stefanie
AU - van Veen, Ilonka
AU - Kips, Johan C.
AU - Mallia, Patrick
AU - Campbell, Deborah A.
AU - Robinson, Douglas S.
AU - Fabbri, Leo M.
AU - Romagnoli, Micaela
PY - 2013
Y1 - 2013
N2 - 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. 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. 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). 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
AB - 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. 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. 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). 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
U2 - https://doi.org/10.1136/thoraxjnl-2012-201815
DO - https://doi.org/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 -