Identification by cluster analysis of patients with asthma and nasal symptoms using the MASK-air® mHealth app

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  • J. Bousquet
  • B. Sousa-Pinto
  • J.M. Anto
  • R. Amaral
  • L. Brussino
  • G W Canonica
  • A. A. Cruz
  • B. Gemicioglu
  • T. Haahtela
  • M. Kupczyk
  • V Kvedariene
  • D E Larenas-Linnemann
  • R. Louis
  • N. Pham-Thi
  • F. Puggioni
  • F. S. Regateiro
  • J. Romantowski
  • J. Sastre
  • N Scichilone
  • L. Taborda-Barata
  • M. T. Ventura
  • I. Agache
  • A. Bedbrook
  • K C Bergmann
  • S. Bosnic-Anticevich
  • M. Bonini
  • L P Boulet
  • G. Brusselle
  • R. Buhl
  • L. Cecchi
  • D. Charpin
  • C. Chaves-Loureiro
  • W. Czarlewski
  • F. de Blay
  • P. Devillier
  • G. Joos
  • M. Jutel
  • L. Klimek
  • P Kuna
  • D. Laune
  • J. L. Pech
  • M. Makela
  • M. Morais-Almeida
  • R. Nadif
  • M. Niedoszytko
  • K. Ohta
  • N. G. Papadopoulos
  • A. Papi
  • D. R. Yeverino
  • N. Roche
  • A. Sá-Sousa
  • B. Samolinski
  • M H Shamji
  • A Sheikh
  • O. S. Usmani
  • A. Valiulis
  • O Vandenplas
  • A Yorgancioglu
  • T Zuberbier
  • J. A. Fonseca

Background: The self-reporting of asthma frequently leads to patient misidentification in epidemiological studies. Strategies combining the triangulation of data sources may help to improve the identification of people with asthma. We aimed to combine information from the self-reporting of asthma, medication use and symptoms to identify asthma patterns in the users of an mHealth app. Methods: We studied MASK-air® users who reported their daily asthma symptoms (assessed by a 0-100 visual analogue scale – “VAS Asthma”) at least three times (either in three different months or in any period). K-means cluster analysis methods were applied to identify asthma patterns based on: (i) whether the user self-reported asthma; (ii) whether the user reported asthma medication use and (iii) VAS asthma. Clusters were compared by the number of medications used, VAS asthma levels and Control of Asthma and Allergic Rhinitis Test (CARAT) levels. Findings: We assessed a total of 8,075 MASK-air® users. The main clustering approach resulted in the identification of seven groups. These groups were interpreted as probable: (i) severe/uncontrolled asthma despite treatment (11.9-16.1% of MASK-air® users); (ii) treated and partly-controlled asthma (6.3-9.7%); (iii) treated and controlled asthma (4.6-5.5%); (iv) untreated uncontrolled asthma (18.2-20.5%); (v) untreated partly-controlled asthma (10.1-10.7%); (vi) untreated controlled asthma (6.7-8.5%) and (vii) no evidence of asthma (33.0-40.2%). This classification was validated in a study of 192 patients enrolled by physicians. Interpretation: We identified seven profiles based on the probability of having asthma and on its level of control. mHealth tools are hypothesis-generating and complement classical epidemiological approaches in identifying patients with asthma.

OriginalsprogEngelsk
TidsskriftPulmonology
Vol/bind29
Udgave nummer4
Sider (fra-til)292-305
ISSN2531-0429
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Dr. Papadopoulos reports personal fees from Novartis, personal fees from Nutricia, personal fees from HAL, personal fees from MENARINI/FAES FARMA, personal fees from SANOFI, personal fees from MYLAN/MEDA, personal fees from BIOMAY, personal fees from AstraZeneca, personal fees from GSK, personal fees from MSD, personal fees from ASIT BIOTECH, personal fees from Boehringer Ingelheim, grants from Gerolymatos International SA, grants from Capricare, outside the submitted work.

Funding Information:
Dr. Bosnic-Anticevich reports grants from TEVA, personal fees from TEVA, personal fees from TEVA, personal fees from AstraZeneca, personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Boehringer Ingelheim, personal fees from GSK, personal fees from Sanofi, personal fees from Mylan, outside the submitted work.

Funding Information:
Dr. Brusselle reports personal fees from Astra Zeneca, personal fees from Boehringer-Ingelheim, personal fees from Chiesi, personal fees from GlaxoSmithKline, personal fees from Novartis, personal fees from Sanofi, personal fees from Teva, grants from MerckSharp&Dohme, outside the submitted work.

Publisher Copyright:
© 2022 Sociedade Portuguesa de Pneumologia

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