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Related Experiment Videos

Classifying asthma severity: objective versus subjective measures.

Melissa K Cowen1, Dorothy B Wakefield, Michelle M Cloutier

  • 1Asthma Center, Connecticut Children's Medical Center, Hartford, Connecticut, USA.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|November 13, 2007
PubMed
Summary
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Asthma severity assessment using clinical history and spirometry showed discrepancies. Four specific questions effectively determined severity, but clinical history and spirometry alone often underestimated actual disease severity in children.

Area of Science:

  • Pediatric Pulmonology
  • Asthma Management
  • Clinical Assessment

Background:

  • National guidelines advocate for clinical history and spirometry in assessing asthma severity.
  • Accurate asthma severity determination is crucial for effective treatment and management.
  • Current methods may have limitations in reflecting the true disease burden in children.

Purpose of the Study:

  • To evaluate the utility of guideline-recommended clinical questions for asthma severity assessment.
  • To compare asthma severity determined by clinical history, clinician judgment, and spirometry.
  • To identify potential underestimation of asthma severity by individual assessment methods.

Main Methods:

  • Cross-sectional study involving 201 children with asthma not on controller therapy.

Related Experiment Videos

  • Utilized six guideline-recommended clinical questions to assess asthma severity.
  • Compared asthma severity determined by clinical history, clinician reports, and spirometry results.

    • Main Results:

    • Four clinical questions (daytime/nocturnal symptoms, school absenteeism, exercise impairment) effectively determined asthma severity.
    • Poor concordance (kappa = 0.02) was observed between clinician-reported and spirometry-determined asthma severity.
    • Clinical history alone underestimated spirometry-determined severity in 27% of children.
    • Spirometry alone underestimated clinician-determined severity in 40% of children.

    Conclusions:

    • A subset of clinical questions can reliably determine asthma severity in children.
    • Relying solely on clinical history or spirometry may lead to underestimation of asthma severity.
    • Integrated assessment approaches are necessary for accurate pediatric asthma severity classification.