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Validation of a single survey that can be used for case identification and assessment of asthma control: the Breathmobile Program.

Kachru, Rita; Morphew, Tricia; Kehl, Sarah; Clement, Loran T; Hanley-Lopez, Jean; Kwong, Kenny Y C; Guterman, Jeffrey J; Jones, Craig A.
Ann Allergy Asthma Immunol; 97(6): 775-83, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17201237

BACKGROUND:

Underdiagnosis of asthma and underrecognition of disease severity in lower socioeconomic populations continue to be significant health care concerns despite national efforts to better educate health care providers.

OBJECTIVE:

To validate a 1-page survey as a point-in-time tool identifying uncontrolled vs controlled asthma and moderate-to-severe disease activity in an urban, lower-socioeconomic pediatric population.

METHODS:

A previously validated survey (the Breathmobile Case Identification Survey) was evaluated as a point-in-time tool for identifying children with poorly controlled disease. Clinical validation was achieved in children (n = 1,826) presenting to a school-based asthma program for either an initial (n = 666) or a follow-up (n = 1,170) visit. Responses were compared with a comprehensive evaluation by a physician specialist as the gold standard. Response patterns were used to construct multimodel tiered scoring algorithms for baseline and follow-up visits that identify children with uncontrolled asthma, and children are likely to have moderate-to-severe disease activity at that time.

RESULTS:

Surveys scored using the developed algorithms identified children with uncontrolled asthma (sensitivity: baseline, 77.0%; follow-up, 71.6%; specificity: baseline, 72.7%; follow-up, 71.5%) and detected moderate-to-severe disease activity (sensitivity: baseline, 69.2%; follow-up, 77.4%; specificity: baseline, 70.2%; follow-up, 70.3%).

CONCLUSIONS:

The Breathmobile Case Identification Survey can be used in lower-socioeconomic, urban populations as a point-in-time tool for identifying children with uncontrolled vs controlled asthma and moderate-to-severe disease activity.
Selo DaSilva