Related Experiment Video

Updated: Aug 24, 2026

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
14:39

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Published on: November 4, 2010

Classifying asthma severity in children: mismatch between symptoms, medication use, and lung function

Leonard B Bacharier1, Robert C Strunk, David Mauger

  • 1Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, One Children's Place, St. Louis, MO 63110, USA. bacharier_L@kids.wustl.edu

American Journal of Respiratory and Critical Care Medicine
|June 3, 2004
PubMed

Insights

Asthma severity in children, based on symptoms and medication, does not align with lung function (FEV1) measures. However, FEV1/FVC ratios decrease as asthma severity increases, indicating airflow obstruction.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Clinical Asthma Research

Background:

  • Current asthma management guidelines classify severity using symptom frequency, medication use, and lung function.
  • The National Asthma Education and Prevention Program/Expert Panel Report 2 Guidelines provide a framework for asthma severity classification.
  • Assessing the concordance between clinical assessment and objective lung function measures is crucial for accurate asthma management.

Purpose of the Study:

  • To evaluate the consistency between asthma severity levels defined by symptom and medication frequency and lung function measures in children.
  • To determine if spirometry results align with the clinical classification of asthma severity in pediatric patients.

Main Methods:

  • Parents of children (5-18 years) with asthma completed questionnaires on symptom frequency and medication use.
  • Children underwent spirometry to assess lung function.
  • Asthma severity was categorized based on symptom and medication data according to established guidelines.

Main Results:

  • FEV1 % predicted did not significantly differ across asthma severity levels.
  • FEV1/FVC ratio decreased significantly as asthma severity increased (p < 0.0001).
  • Abnormal FEV1/FVC ratios were more prevalent in children with increased asthma severity.

Conclusions:

  • Asthma severity classification based on symptom and medication frequency in children does not correlate with FEV1 measures.
  • FEV1 remains normal in many children, even with severe persistent asthma.
  • FEV1/FVC ratio serves as a more sensitive indicator of airflow limitation that worsens with increasing asthma severity in pediatric populations.

Related Concept Videos

Asthma-III: Symptoms and Complications01:24

Asthma-III: Symptoms and Complications

Asthma, a common chronic respiratory condition, is classified considering the frequency and severity of symptoms alongside lung function impairment. Understanding this classification is essential for appropriate treatment and management. Here's a detailed look at the classification of asthma and its clinical features and complications:
Classification of Asthma
Asthma-II: Pathophysiology and Classification01:26

Asthma-II: Pathophysiology and Classification

Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Asthma-IV: Diagnostic and Management01:30

Asthma-IV: Diagnostic and Management

The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Asthma III: Clinical Manifestations01:13

Asthma III: Clinical Manifestations

Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...
Asthma I: Introduction01:28

Asthma I: Introduction

Asthma is a chronic inflammatory disorder of the airways characterized by variable airflow obstruction and heightened bronchial responsiveness to a wide range of triggers. The underlying inflammation leads to airway swelling, mucus hypersecretion, and smooth muscle constriction, all of which narrow the airway lumen and impede airflow. Clinically, asthma presents with recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, symptoms that typically vary in intensity and...
Asthma-I: Introduction01:29

Asthma-I: Introduction

Asthma is a chronic respiratory ailment that requires careful management due to its varying symptoms and influencing factors. It is characterized by airway inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction, leading to symptoms like wheezing, shortness of breath, chest tightness, and coughing. The symptom frequency and intensity may vary considerably over time. It is also linked to immune system responses to allergens and irritants, highlighting the complex...