Relevance of individual bronchial symptoms for asthma diagnosis and control in patients with rhinitis: A MASK‐air study

Author:

Sousa‐Pinto Bernardo12,Louis Gilles34ORCID,Vieira Rafael J.12ORCID,Czarlewski Wienczyslawa56,Anto Josep M.789,Amaral Rita12,Sá‐Sousa Ana12,Brussino Luisa1011,Canonica G. Walter1213,Loureiro Claudia Chaves1415,Cruz Alvaro A.16,Gemicioglu Bilun1718,Haahtela Tari19,Kupczyk Maciej20,Kvedariene Violeta2122,Larenas‐Linnemann Desirée E.23ORCID,Pham‐Thi Nhân242526,Puggioni Francesca27,Regateiro Frederico S.28293031,Romantowski Jan32,Sastre Joaquin33,Scichilone Nicola34,Taborda‐Barata Luis3135,Ventura Maria Teresa3637ORCID,Agache Ioana38,Bedbrook Anna639,Benfante Alida34,Bergmann Karl C.4041,Bosnic‐Anticevich Sinthia4243,Bonini Matteo4445,Boulet Louis‐Philippe46,Brusselle Guy47,Buhl Roland48,Cecchi Lorenzo49,Charpin Denis50,Costa Elisio M.51,Del Giacco Stefano52,Jutel Marek5354,Klimek Ludger5556,Kuna Piotr20,Laune Daniel57,Makela Mika19,Morais‐Almeida Mario58,Nadif Rachel5960,Niedoszytko Marek3132,Papadopoulos Nikolaos G.61,Papi Alberto62ORCID,Pfaar Oliver63ORCID,Rivero‐Yeverino Daniela64,Roche Nicolas606566,Samolinski Boleslaw67,Shamji Mohamed H.4568ORCID,Sheikh Aziz69,Ulrik Charlotte Suppli7071,Usmani Omar S.457172,Valiulis Arunas7374,Yorgancioglu Arzu75,Zuberbier Torsten4041ORCID,Fonseca Joao A.12,Pétré Benoit3,Louis Renaud476,Bousquet Jean639404160ORCID,

Affiliation:

1. MEDCIDS ‐ Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine University of Porto Porto Portugal

2. Faculty of Medicine CINTESIS@RISE ‐ Health Research Network University of Porto Porto Portugal

3. Department of Public Health University of Liège Liège Belgium

4. GIGA I3 Research Group University of Liège Liège Belgium

5. Medical Consulting Czarlewski Levallois France

6. MASK‐air Montpellier France

7. ISGlobal Barcelona Institute for Global Health Barcelona Spain

8. Universitat Pompeu Fabra (UPF) Barcelona Spain

9. CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain

10. Department of Medical Sciences University of Torino Torino Italy

11. Allergy and Clinical Immunology Unit Mauriziano Hospital Torino Italy

12. Department of Biomedical Sciences Humanitas University Milan Italy

13. Asthma and Allergy Unit IRCCS Humanitas Research Hospital Milan Italy

14. Department of Pneumology Faculty of Medicine Coimbra University Hospital Coimbra Portugal

15. Coimbra Institute for Clinical and Biomedical Research, CIBB Coimbra Portugal

16. Fundaçao ProAR Federal University of Bahia and GARD/WHO Planning Group Salvador Bahia Brazil

17. Department of Pulmonary Diseases Faculty of Medicine Istanbul University‐Cerrahpaşa Cerrahpaşa Istanbul Turkey

18. Institute of Pulmonology and Tuberculosis Istanbul University‐Cerrahpaşa Istanbul Turkey

19. Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland

20. Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Lodz Poland

21. Institute of Clinical Medicine Clinic of Chest Diseases and Allergology Faculty of Medicine Vilnius University Vilnius Lithuania

22. Department of Pathology Institute of Biomedical Sciences Faculty of Medicine Vilnius University Vilnius Lithuania

23. Center of Excellence in Asthma and Allergy Médica Sur Clinical Foundation and Hospital México City Mexico

24. Ecole Polytechnique de Palaiseau Palaiseau France

25. IRBA (Institut de Recherche Bio‐Médicale des Armées) Brétigny sur Orge France

26. Université Paris Cité Paris France

27. IRCCS Humanitas Research Center Personalized Medicine Asthma & Allergy Rozzano, Milan Italy

28. Allergy and Clinical Immunology Unit Centro Hospitalar e Universitário de Coimbra Coimbra Portugal

29. Faculty of Medicine Center for Innovative Biomedicine and Biotechnology (CIBB) University of Coimbra Coimbra Portugal

30. Faculty of Medicine Institute of Immunology University of Coimbra Coimbra Portugal

31. UBIAir ‐ Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research Centre University of Beira Interior Covilhã Portugal

32. Department of Allergology Medical University of Gdańsk Gdansk Poland

33. Allergy Service Fundacion Jimenez Diaz Autonoma University of Madrid CIBERES‐ISCIII Madrid Spain

34. PROMISE Department University of Palermo Palermo Italy

35. Department of Immunoallergology Cova da Beira University Hospital Centre Covilhã Portugal

36. Allergy and Clinical Immunology University of Bari Medical School Bari Italy

37. Institute of Sciences of Food Production National Research Council (ISPA‐CNR) Bari Italy

38. Faculty of Medicine Transylvania University Brasov Brasov Romania

39. ARIA Montpellier France

40. Institute of Allergology Charité—Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany

41. Fraunhofer Institute for Translational Medicine and Pharmacology ITMP Immunology and Allergology Berlin Germany

42. Quality Use of Respiratory Medicines Group Woolcock Institute of Medical Research Sydney New South Wales Australia

43. Macquarie Medical School Macquarie University Macquarie Park New South Wales Australia

44. Department of Public Health and Infectious Diseases Sapienza University of Rome Rome Italy

45. National Heart and Lung Institute (NHLI) Imperial College London London UK

46. Quebec Heart and Lung Institute Laval University Quebec City Quebec Canada

47. Department of Respiratory Medicine Ghent University Hospital Ghent Belgium

48. Department of Pulmonary Medicine Mainz University Hospital Mainz Germany

49. SOS Allergology and Clinical Immunology USL Toscana Centro Prato Italy

50. Clinique des Bronches Allergie et Sommeil Hôpital Nord Marseille France

51. CINTESIS@RISE Biochemistry Lab Faculty of Pharmacy and Competence Center on Active and Healthy Ageing University of Porto Porto Portugal

52. Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology University Hospital “Duilio Casula” University of Cagliari Cagliari Italy

53. Department of Clinical Immunology Wrocław Medical University Wroclaw Poland

54. ALL‐MED Medical Research Institute Wroclaw Poland

55. Department of Otolaryngology, Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany

56. Center for Rhinology and Allergology Wiesbaden Germany

57. KYomed INNOV Montpellier France

58. Allergy Center CUF Descobertas Hospital Lisbon Portugal

59. Université Paris‐Saclay UVSQ University Paris‐Sud Villejuif France

60. Inserm Equipe d’Epidémiologie Respiratoire Intégrative CESP Villejuif France

61. Allergy Department 2nd Pediatric Clinic University of Athens Athens Greece

62. Respiratory Medicine Department of Translational Medicine University of Ferrara Ferrara Italy

63. Section of Rhinology and Allergy Department of Otorhinolaryngology Head and Neck Surgery University Hospital Marburg Philipps‐Universität Marburg Marburg Germany

64. Servicio de Alergia e Inmunología clínica Hospital Universitario de Puebla Puebla México

65. Pneumologie AP‐HP Centre Université de Paris Cité Hôpital Cochin Paris France

66. UMR 1016 Institut Cochin Paris France

67. Department of Prevention of Environmental Hazards Allergology and Immunology Medical University of Warsaw Warsaw Poland

68. NIHR Imperial Biomedical Research Centre London UK

69. Usher Institute The University of Edinburgh Edinburgh UK

70. Department of Respiratory Medicine Copenhagen University Hospital‐Hvidovre Copenhagen Denmark

71. Institute of Clinical Medicine University of Copenhagen Copenhagen Denmark

72. Airways Disease Section Royal Brompton Hospital London UK

73. Interdisciplinary Research Group of Human Ecology Institute of Clinical Medicine and Institute of Health Sciences Medical Faculty of Vilnius University Vilnius Lithuania

74. European Academy of Paediatrics (EAP/UEMS‐SP) Brussel Belgium

75. Department of Pulmonary Diseases Faculty of Medicine Celal Bayar University Manisa Turkey

76. Department of Pulmonary Medicine CHU Liège Liège Belgium

Abstract

AbstractRationaleIt is unclear how each individual asthma symptom is associated with asthma diagnosis or control.ObjectivesTo assess the performance of individual asthma symptoms in the identification of patients with asthma and their association with asthma control.MethodsIn this cross‐sectional study, we assessed real‐world data using the MASK‐air® app. We compared the frequency of occurrence of five asthma symptoms (dyspnea, wheezing, chest tightness, fatigue and night symptoms, as assessed by the Control of Allergic Rhinitis and Asthma Test [CARAT] questionnaire) in patients with probable, possible or no current asthma. We calculated the sensitivity, specificity and predictive values of each symptom, and assessed the association between each symptom and asthma control (measured using the e‐DASTHMA score). Results were validated in a sample of patients with a physician‐established diagnosis of asthma.Measurement and Main ResultsWe included 951 patients (2153 CARAT assessments), with 468 having probable asthma, 166 possible asthma and 317 no evidence of asthma. Wheezing displayed the highest specificity (90.5%) and positive predictive value (90.8%). In patients with probable asthma, dyspnea and chest tightness were more strongly associated with asthma control than other symptoms. Dyspnea was the symptom with the highest sensitivity (76.1%) and the one consistently associated with the control of asthma as assessed by e‐DASTHMA. Consistent results were observed when assessing patients with a physician‐made diagnosis of asthma.ConclusionsWheezing and chest tightness were the asthma symptoms with the highest specificity for asthma diagnosis, while dyspnea displayed the highest sensitivity and strongest association with asthma control.

Publisher

Wiley

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