Validation of the adult asthma epidemiological score: a secondary analysis of the EPI-ASTHMA population-based study

• Type: Article in International Scientific Journal
• Date: 2024

Authors

Laranjeira, C (Author) Other; Jacome, C (Author) Other; Amaral, R (Author) Other; Bernardo, F (Author) Other; Correia-de-Sousa, J (Author) Other; Fonseca, J (Author) FMUP

Journal

Title: BMJ Open

Vol. 14

ISSN: 2044-6055

Publisher: BMJ PUBLISHING GROUP

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-017-DXW

DOI: 10.1136/bmjopen-2024-086493

Abstract (EN): Objective The A2 score is an eight-question patient-reported outcome measure that has been validated for ruling in (score >= 4) and ruling out (score 0-1) asthma. However, this screening tool has been validated in a cohort similar to the derivation cohort used. This study aims to validate the predictive accuracy of the A2 score in a primary care population against general practitioner (GP) clinical assessment and to determine whether the proposed cut-offs are the most appropriate. Design This accuracy study is a secondary analysis of the EPI-ASTHMA population-based study. Setting Primary care centres in Portugal. Participants Random adult participants answered the A2 score by phone interview. Outcomes Those with an A2 score >= 1 (plus 5% with an A2 score of 0) were invited to a diagnostic visit carried out by a GP to confirm or not a diagnosis of asthma. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves. Results A total of 1283 participants (median 54 (p25-p75 43-66) years; 60% women) were analysed. The A2 score showed high discriminatory power in identifying asthma, with an area under the ROC curve of 82.9% (95% CI 80.4% to 85.4%). The proposed cut-off >= 4 was the most appropriate to rule in asthma (specificity 83.1%, positive predictive value 62.4%, accuracy 78%). Similarly, the proposed cut-off<2 was the most suitable for excluding asthma (sensitivity 92.7%, negative predictive value 93.7%, accuracy 60.5%). Conclusions The A2 score is a useful tool to identify patients with asthma in a primary care population. Trial registration number NCT0516961.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6