Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study
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Development and validation of an electronic daily control score for asthma (e-DASTHMA) : a real-world direct patient data study. / Sousa-Pinto, Bernardo; Jácome, Cristina; Pereira, Ana Margarida; Regateiro, Frederico S.; Almeida, Rute; Czarlewski, Wienczyslawa; Kulus, Marek; Shamji, Mohamed H.; Boulet, Louis-Philippe; Bonini, Matteo; Brussino, Luisa; Canonica, G. Walter; Cruz, Alvaro A.; Gemicioglu, Bilun; Haahtela, Tari; Kupczyk, Maciej; Kvedariene, Violeta; Larenas-Linnemann, Desirée; Louis, Renaud; Niedoszytko, Marek; Pham-Thi, Nhân; Puggioni, Francesca; Romantowski, Jan; Sastre, Joaquin; Scichilone, Nicola; Taborda-Barata, Luis; Ventura, Maria Teresa; Vieira, Rafael José; Agache, Ioana; Bedbrook, Anna; Bergmann, Karl C.; Amaral, Rita; Azevedo, Luís Filipe; Bosnic-Anticevich, Sinthia; Brusselle, Guy; Buhl, Roland; Cecchi, Lorenzo; Charpin, Denis; Loureiro, Claudia Chaves; de Blay, Frédéric; Del Giacco, Stefano; Devillier, Philippe; Jassem, Ewa; Joos, Guy; Jutel, Marek; Klimek, Ludger; Kuna, Piotr; Laune, Daniel; Pech, Jorge Luna; Makela, Mika; Morais-Almeida, Mario; Nadif, Rachel; Neffen, Hugo E.; Ohta, Ken; Papadopoulos, Nikolaos G.; Papi, Alberto; Pétré, Benoit; Pfaar, Oliver; Yeverino, Daniela Rivero; Cordeiro, Carlos Robalo; Roche, Nicolas; Sá-Sousa, Ana; Samolinski, Boleslaw; Sheikh, Aziz; Ulrik, Charlotte Suppli; Usmani, Omar S.; Valiulis, Arunas; Vandenplas, Olivier; Vieira-Marques, Pedro; Yorgancioglu, Arzu; Zuberbier, Torsten; Anto, Josep M.; Fonseca, João A.; Bousquet, Jean.
In: The Lancet Digital Health, Vol. 5, No. 4, 2023, p. e227-e238.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Development and validation of an electronic daily control score for asthma (e-DASTHMA)
T2 - a real-world direct patient data study
AU - Sousa-Pinto, Bernardo
AU - Jácome, Cristina
AU - Pereira, Ana Margarida
AU - Regateiro, Frederico S.
AU - Almeida, Rute
AU - Czarlewski, Wienczyslawa
AU - Kulus, Marek
AU - Shamji, Mohamed H.
AU - Boulet, Louis-Philippe
AU - Bonini, Matteo
AU - Brussino, Luisa
AU - Canonica, G. Walter
AU - Cruz, Alvaro A.
AU - Gemicioglu, Bilun
AU - Haahtela, Tari
AU - Kupczyk, Maciej
AU - Kvedariene, Violeta
AU - Larenas-Linnemann, Desirée
AU - Louis, Renaud
AU - Niedoszytko, Marek
AU - Pham-Thi, Nhân
AU - Puggioni, Francesca
AU - Romantowski, Jan
AU - Sastre, Joaquin
AU - Scichilone, Nicola
AU - Taborda-Barata, Luis
AU - Ventura, Maria Teresa
AU - Vieira, Rafael José
AU - Agache, Ioana
AU - Bedbrook, Anna
AU - Bergmann, Karl C.
AU - Amaral, Rita
AU - Azevedo, Luís Filipe
AU - Bosnic-Anticevich, Sinthia
AU - Brusselle, Guy
AU - Buhl, Roland
AU - Cecchi, Lorenzo
AU - Charpin, Denis
AU - Loureiro, Claudia Chaves
AU - de Blay, Frédéric
AU - Del Giacco, Stefano
AU - Devillier, Philippe
AU - Jassem, Ewa
AU - Joos, Guy
AU - Jutel, Marek
AU - Klimek, Ludger
AU - Kuna, Piotr
AU - Laune, Daniel
AU - Pech, Jorge Luna
AU - Makela, Mika
AU - Morais-Almeida, Mario
AU - Nadif, Rachel
AU - Neffen, Hugo E.
AU - Ohta, Ken
AU - Papadopoulos, Nikolaos G.
AU - Papi, Alberto
AU - Pétré, Benoit
AU - Pfaar, Oliver
AU - Yeverino, Daniela Rivero
AU - Cordeiro, Carlos Robalo
AU - Roche, Nicolas
AU - Sá-Sousa, Ana
AU - Samolinski, Boleslaw
AU - Sheikh, Aziz
AU - Ulrik, Charlotte Suppli
AU - Usmani, Omar S.
AU - Valiulis, Arunas
AU - Vandenplas, Olivier
AU - Vieira-Marques, Pedro
AU - Yorgancioglu, Arzu
AU - Zuberbier, Torsten
AU - Anto, Josep M.
AU - Fonseca, João A.
AU - Bousquet, Jean
N1 - Publisher Copyright: © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
PY - 2023
Y1 - 2023
N2 - Background: Validated questionnaires are used to assess asthma control over the past 1–4 weeks from reporting. However, they do not adequately capture asthma control in patients with fluctuating symptoms. Using the Mobile Airways Sentinel Network for airway diseases (MASK-air) app, we developed and validated an electronic daily asthma control score (e-DASTHMA). Methods: We used MASK-air data (freely available to users in 27 countries) to develop and assess different daily control scores for asthma. Data-driven control scores were developed based on asthma symptoms reported by a visual analogue scale (VAS) and self-reported asthma medication use. We included the daily monitoring data from all MASK-air users aged 16–90 years (or older than 13 years to 90 years in countries with a lower age of digital consent) who had used the app in at least 3 different calendar months and had reported at least 1 day of asthma medication use. For each score, we assessed construct validity, test–retest reliability, responsiveness, and accuracy. We used VASs on dyspnoea and work disturbance, EQ-5D-VAS, Control of Allergic Rhinitis and Asthma Test (CARAT), CARAT asthma, and Work Productivity and Activity Impairment: Allergy Specific (WPAI:AS) questionnaires as comparators. We performed an internal validation using MASK-air data from Jan 1 to Oct 12, 2022, and an external validation using a cohort of patients with physician-diagnosed asthma (the INSPIRERS cohort) who had had their diagnosis and control (Global Initiative for Asthma [GINA] classification) of asthma ascertained by a physician. Findings: We studied 135 635 days of MASK-air data from 1662 users from May 21, 2015, to Dec 31, 2021. The scores were strongly correlated with VAS dyspnoea (Spearman correlation coefficient range 0·68–0·82) and moderately correlated with work comparators and quality-of-life-related comparators (for WPAI:AS work, we observed Spearman correlation coefficients of 0·59–0·68). They also displayed high test–retest reliability (intraclass correlation coefficients range 0·79–0·95) and moderate-to-high responsiveness (correlation coefficient range 0·69–0·79; effect size measures range 0·57–0·99 in the comparison with VAS dyspnoea). The best-performing score displayed a strong correlation with the effect of asthma on work and school activities in the INSPIRERS cohort (Spearman correlation coefficients 0·70; 95% CI 0·61–0·78) and good accuracy for the identification of patients with uncontrolled or partly controlled asthma according to GINA (area under the receiver operating curve 0·73; 95% CI 0·68–0·78). Interpretation: e-DASTHMA is a good tool for the daily assessment of asthma control. This tool can be used as an endpoint in clinical trials as well as in clinical practice to assess fluctuations in asthma control and guide treatment optimisation. Funding: None.
AB - Background: Validated questionnaires are used to assess asthma control over the past 1–4 weeks from reporting. However, they do not adequately capture asthma control in patients with fluctuating symptoms. Using the Mobile Airways Sentinel Network for airway diseases (MASK-air) app, we developed and validated an electronic daily asthma control score (e-DASTHMA). Methods: We used MASK-air data (freely available to users in 27 countries) to develop and assess different daily control scores for asthma. Data-driven control scores were developed based on asthma symptoms reported by a visual analogue scale (VAS) and self-reported asthma medication use. We included the daily monitoring data from all MASK-air users aged 16–90 years (or older than 13 years to 90 years in countries with a lower age of digital consent) who had used the app in at least 3 different calendar months and had reported at least 1 day of asthma medication use. For each score, we assessed construct validity, test–retest reliability, responsiveness, and accuracy. We used VASs on dyspnoea and work disturbance, EQ-5D-VAS, Control of Allergic Rhinitis and Asthma Test (CARAT), CARAT asthma, and Work Productivity and Activity Impairment: Allergy Specific (WPAI:AS) questionnaires as comparators. We performed an internal validation using MASK-air data from Jan 1 to Oct 12, 2022, and an external validation using a cohort of patients with physician-diagnosed asthma (the INSPIRERS cohort) who had had their diagnosis and control (Global Initiative for Asthma [GINA] classification) of asthma ascertained by a physician. Findings: We studied 135 635 days of MASK-air data from 1662 users from May 21, 2015, to Dec 31, 2021. The scores were strongly correlated with VAS dyspnoea (Spearman correlation coefficient range 0·68–0·82) and moderately correlated with work comparators and quality-of-life-related comparators (for WPAI:AS work, we observed Spearman correlation coefficients of 0·59–0·68). They also displayed high test–retest reliability (intraclass correlation coefficients range 0·79–0·95) and moderate-to-high responsiveness (correlation coefficient range 0·69–0·79; effect size measures range 0·57–0·99 in the comparison with VAS dyspnoea). The best-performing score displayed a strong correlation with the effect of asthma on work and school activities in the INSPIRERS cohort (Spearman correlation coefficients 0·70; 95% CI 0·61–0·78) and good accuracy for the identification of patients with uncontrolled or partly controlled asthma according to GINA (area under the receiver operating curve 0·73; 95% CI 0·68–0·78). Interpretation: e-DASTHMA is a good tool for the daily assessment of asthma control. This tool can be used as an endpoint in clinical trials as well as in clinical practice to assess fluctuations in asthma control and guide treatment optimisation. Funding: None.
U2 - 10.1016/S2589-7500(23)00020-1
DO - 10.1016/S2589-7500(23)00020-1
M3 - Journal article
C2 - 36872189
AN - SCOPUS:85150395888
VL - 5
SP - e227-e238
JO - The Lancet Digital Health
JF - The Lancet Digital Health
SN - 2589-7500
IS - 4
ER -
ID: 386600048