Vianna E O, García C A, Bettiol H, Barbieri M A, Rona R J
Department of Medicine, Medical School of Ribeirão Preto, University of S. Paulo, Ribeirão Preto, Brazil.
Allergy. 2007 Oct;62(10):1146-51. doi: 10.1111/j.1398-9995.2007.01467.x.
An asthma score was proposed in the European Community Respiratory Health Survey (ECRHS) framework, as dichotomous definitions could be less appropriate in the study of chronic diseases. The aims of this study were to assess the value of this asthma score in comparison with other definitions of asthma in another population setting, using as criteria bronchial hyperresponsiveness (BHR) to methacholine and diagnosed asthma, and the association of these definitions to known risk factors of asthma.
We used the ECRHS questionnaire on 2063 Brazilians, aged 23-25 years, and measured their BHR. We assessed the positive and negative likelihood ratios (PLR and NLR) of the asthma score (0-8), a three question score (ECRHS definition) and single asthma symptoms in relation to BHR and diagnosed asthma.
The PLR were relatively low for all asthma definitions with odd ratios varying from 1.47 for asthma score to 5.50 for wheeze and waking with breathlessness without a cold. The NLR were near 1. The PLR were lower for assessments using the score than for dichotomous assessments or the ECRHS definition. The PLR increased with asthma scores, but the prevalence with higher scores was too low for useful analysis. The asthma score was slightly better for identifying associations from a set of known risk factors than the other two approaches.
Our study provided little support for a greater validity of this asthma score over other asthma definitions, and only marginal advantage for identifying risk factors.
在欧洲共同体呼吸健康调查（ECRHS）框架中提出了哮喘评分，因为二分法定义在慢性病研究中可能不太合适。本研究的目的是在另一人群中，将该哮喘评分与哮喘的其他定义进行比较，以对乙酰甲胆碱的支气管高反应性（BHR）和已诊断的哮喘为标准，评估该哮喘评分的价值，以及这些定义与已知哮喘危险因素的关联。
我们对2063名年龄在23 - 25岁的巴西人使用了ECRHS问卷，并测量了他们的BHR。我们评估了哮喘评分（0 - 8分）、三问题评分（ECRHS定义）和单一哮喘症状相对于BHR和已诊断哮喘的阳性和阴性似然比（PLR和NLR）。
所有哮喘定义的PLR相对较低，比值比从哮喘评分的1.47到喘息和无感冒时因呼吸困难醒来的5.50不等。NLR接近1。使用评分进行评估的PLR低于二分法评估或ECRHS定义。PLR随哮喘评分增加，但高分的患病率过低，无法进行有效分析。在从一组已知危险因素中识别关联方面，哮喘评分比其他两种方法略好。
我们的研究几乎没有支持该哮喘评分比其他哮喘定义具有更高的有效性，在识别危险因素方面只有微弱优势。
