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Defining asthma in epidemiological studies.

J Pekkanen1, N Pearce

  • 1Unit of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.

The European Respiratory Journal
|November 26, 1999
PubMed
Summary
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Defining asthma in epidemiological studies requires careful consideration of study aims. Symptom questionnaires are best for prevalence comparisons, while symptomatic bronchial hyperresponsiveness (BHR) aids in risk estimation.

Area of Science:

  • Epidemiology
  • Respiratory Medicine
  • Clinical Research Methodology

Background:

  • Asthma definition in epidemiological studies is debated.
  • Symptomatic bronchial hyperresponsiveness (BHR) has been proposed as a definition.
  • Current definitions require critical evaluation against clinical assessments.

Purpose of the Study:

  • To critically examine the validity of defining asthma using symptomatic BHR and other methods.
  • To review population-based studies validating BHR and symptom questionnaires against clinical asthma definitions.
  • To determine the most appropriate asthma definition based on study objectives.

Main Methods:

  • Review of population-based studies.
  • Validation of BHR and symptom questionnaires against clinical asthma assessment.

Related Experiment Videos

  • Analysis of Youden's Index (sensitivity + specificity - 1) for prevalence comparisons.
  • Evaluation of positive predictive value for risk estimation studies.

    • Main Results:

    • A single asthma definition is not universally applicable.
    • Symptom questionnaires demonstrate better sensitivity and Youden's Index than BHR for prevalence studies.
    • BHR shows comparable or better specificity but significantly lower sensitivity.
    • Symptomatic BHR, severe symptoms, or asthma diagnoses are more suitable for risk studies.

    Conclusions:

    • The optimal asthma definition depends on the specific research question.
    • Standardized symptom questionnaires are recommended for initial prevalence comparisons.
    • BHR and symptom data should generally be analyzed separately due to poor agreement.
    • Further research can supplement questionnaires with BHR testing in subsamples to explore prevalence differences.