Sapienza University of Rome, Rome, Italy.
NC IUL University, London, UK.
BMC Pulm Med. 2021 Nov 14;21(1):369. doi: 10.1186/s12890-021-01730-0.
Research into the effects of asthma treatments on the extra-pulmonary symptoms of severe asthma is limited by the absence of a suitable questionnaire. The aim was to create a questionnaire suitable for intervention studies by selecting symptoms that are statistically associated with asthma pathology and therefore may improve when pathology is reduced.
Patients attending a specialist asthma clinic completed the 65-item General Symptom Questionnaire (GSQ-65), a questionnaire validated for assessing symptoms of people with multiple medically unexplained symptoms. Lung function (FEV1%) and cumulative oral corticosteroids (OCS) calculated from maintenance dose plus exacerbations were obtained from clinic records. Pathology was represented by the two components of a principal component analysis (PCA) of FEV1% and OCS. LASSO regression was used to select symptoms that had high coefficients with these two principal components and occurred frequently in severe asthma.
100 patients provided data. PCA revealed two components, one where FEV1% and OCS were inversely related and another where they were directly related. LASSO regression revealed 39 symptoms with non-zero coefficients on one or more of the two principal components from which 16 symptoms were selected for the GSQ-A on the basis of magnitude of coefficient and frequency. Asthma symptoms measured by asthma control questionnaires were excluded. The GSQ-A correlated 0.33 and - 0.34 (p = 0.001) with the two principal components.
The GSQ-A assesses the frequency of 16 heterogenous non-respiratory symptoms that are associated with asthma severity using the statistical combination of FEV1% and OCS.
由于缺乏合适的问卷，对哮喘治疗对严重哮喘的肺外症状的影响的研究受到限制。目的是通过选择与哮喘病理统计学相关的症状来创建适合干预研究的问卷，因此当病理减轻时这些症状可能会改善。
在专科哮喘诊所就诊的患者完成了 65 项一般症状问卷（GSQ-65），该问卷经过验证，可用于评估患有多种医学无法解释的症状的人群的症状。从就诊记录中获得肺功能（FEV1%）和累积口服皮质类固醇（OCS），由维持剂量加加重期计算得出。病理表现为 FEV1%和 OCS 的主成分分析（PCA）的两个组成部分。使用 LASSO 回归选择与这两个主要成分高度相关且在严重哮喘中经常发生的症状。
100 名患者提供了数据。PCA 显示了两个组成部分，一个是 FEV1%和 OCS 呈反比关系，另一个是 FEV1%和 OCS 呈正相关。LASSO 回归显示，有 39 个症状在一个或多个主要成分上具有非零系数，其中 16 个症状基于系数的大小和频率被选为 GSQ-A。哮喘控制问卷测量的哮喘症状被排除在外。GSQ-A 与两个主要成分的相关性为 0.33 和 -0.34（p=0.001）。
GSQ-A 使用 FEV1%和 OCS 的统计组合评估了与哮喘严重程度相关的 16 种异质非呼吸症状的频率。
