Asthma-like symptoms assessment through ECRHS screening questionnaire scoring

Area of Science:

• Epidemiology
• Respiratory Medicine
• Statistical Modeling

Background:

• The definition and diagnosis of asthma remain subjects of ongoing scientific discussion.
• The European Community Respiratory Health Survey (ECRHS) is a key multinational study assessing asthma prevalence in European adults aged 20-44.
• Standardized screening questionnaires are crucial for large-scale epidemiological research.

Purpose of the Study:

• To propose and validate a novel scoring methodology for the ECRHS self-administered screening questionnaire.
• To enhance the diagnostic utility of the ECRHS questionnaire for asthma identification.
• To establish a reproducible scoring system for optimizing information extraction from survey data.

Main Methods:

• A single latent factor/dimension was identified underlying the nine dichotomous items of the ECRHS screening questionnaire.
• Homogeneity Analysis by Alternating Least Squares (HOMALS) was employed to construct a summary score.
• The scoring method was validated against clinical diagnoses from Italian centers, including expert interviews, lung function, and allergy tests.

Main Results:

• The developed scoring method demonstrated a sensitivity of 75.1% and a specificity of 80.1% at the optimal Receiver Operating Characteristic (ROC) threshold.
• The HOMALS analysis confirmed a unidimensional structure for the screening questionnaire items.
• The proposed scoring approach effectively optimizes the information captured by the ECRHS questionnaire.

Conclusions:

• A reproducible and validated scoring method for the ECRHS questionnaire has been established.
• The new scoring system improves the diagnostic accuracy for asthma detection in the adult population.
• This methodology offers a valuable tool for epidemiological studies on asthma prevalence and risk factors.