Chipps Bradley E, Murphy Kevin R, Wise Robert A, McCann William A, Beuther David A, Reibman Joan, George Maureen, Gilbert Ileen, Eudicone James M, Gandhi Hitesh N, Harding Gale, Ross Melissa, Zeiger Robert S
Capital Allergy & Respiratory Disease Center, Sacramento, California.
Division of Allergy, Asthma and Immunology, Boys Town National Research Hospital, Boys Town, Nebraska.
Ann Allergy Asthma Immunol. 2022 May;128(5):544-552.e3. doi: 10.1016/j.anai.2022.01.035. Epub 2022 Feb 3.
Recurrent assessment of asthma control is essential to evaluating disease stability and intervention impacts. An assessment that can be administered between annual clinic visits is needed. The Asthma Impairment and Risk Questionnaire (AIRQ) is a cross-sectionally validated, 10-item, yes or no, composite control tool evaluating previous 2-week symptoms and previous 12-month exacerbations.
To evaluate the construct validity of the AIRQ using a 3-month recall period for exacerbation-based risk questions and retaining the 2-week recall for symptom-based impairment items.
At baseline, patients completed the AIRQ with 12-month recall exacerbation items, Asthma Control Test (ACT), St. George's Respiratory Questionnaire (SGRQ), and global self-assessments of asthma risk, control, and symptom severity. Patient-reported exacerbations were captured monthly. The AIRQ with 3-month recall exacerbation items, ACT, and global self-assessments was administered at months 3, 6, and 9, and SGRQ at month 6.
A total of 1112 patients aged 12 years or older were enrolled (mean [SD] age, 43.9 [19.5] years). The AIRQ and each administration of the AIRQ with 3-month recall exacerbation items classified asthma control similarly to an ACT plus exacerbation validation standard. For both AIRQ versions, SGRQ scores were higher with worsening asthma control (P < .001). At months 3, 6, and 9, worse AIRQ control levels were associated with higher proportions of patients with 1 or more and 2 or more exacerbations in the previous 3 months and patient global self-assessments indicating greater asthma morbidity (all P < .001).
The AIRQ using exacerbation risk items with a 3-month recall period exhibits construct validity for classifying current asthma control and can be administered between annual AIRQ assessments.
对哮喘控制情况进行反复评估对于评估疾病稳定性和干预效果至关重要。需要一种能够在年度门诊就诊之间进行的评估方法。哮喘损害与风险问卷(AIRQ)是一种经过横断面验证的、包含10个是或否问题的综合控制工具,用于评估前两周的症状和前12个月的急性加重情况。
使用3个月回忆期来回答基于急性加重的风险问题,并保留2周回忆期来回答基于症状的损害项目,以评估AIRQ的结构效度。
在基线时,患者完成了包含12个月回忆期急性加重项目的AIRQ、哮喘控制测试(ACT)、圣乔治呼吸问卷(SGRQ)以及对哮喘风险、控制和症状严重程度的整体自我评估。每月记录患者报告的急性加重情况。在第3、6和9个月时,对患者进行包含3个月回忆期急性加重项目的AIRQ、ACT和整体自我评估,在第6个月时进行SGRQ评估。
共纳入1112名12岁及以上的患者(平均[标准差]年龄为43.9[19.5]岁)。AIRQ以及每次使用3个月回忆期急性加重项目的AIRQ评估对哮喘控制情况的分类,与ACT加急性加重验证标准的分类相似。对于两个版本的AIRQ,随着哮喘控制情况恶化,SGRQ得分更高(P < .001)。在第3、6和9个月时,AIRQ控制水平越差,在前3个月内有1次或更多次以及2次或更多次急性加重的患者比例越高,且患者的整体自我评估表明哮喘发病率更高(所有P < .001)。
使用3个月回忆期急性加重项目的AIRQ在对当前哮喘控制情况进行分类方面具有结构效度,并且可以在年度AIRQ评估之间进行。