Relevance of individual bronchial symptoms for asthma diagnosis and control in patients with rhinitis: A MASK-air study.
Sousa-Pinto B., Louis G., Vieira RJ., Czarlewski W., Anto JM., Amaral R., Sá-Sousa A., Brussino L., Canonica GW., Loureiro CC., Cruz AA., Gemicioglu B., Haahtela T., Kupczyk M., Kvedariene V., Larenas-Linnemann DE., Pham-Thi N., Puggioni F., Regateiro FS., Romantowski J., Sastre J., Scichilone N., Taborda-Barata L., Ventura MT., Agache I., Bedbrook A., Benfante A., Bergmann KC., Bosnic-Anticevich S., Bonini M., Boulet L-P., Brusselle G., Buhl R., Cecchi L., Charpin D., Costa EM., Del Giacco S., Jutel M., Klimek L., Kuna P., Laune D., Makela M., Morais-Almeida M., Nadif R., Niedoszytko M., Papadopoulos NG., Papi A., Pfaar O., Rivero-Yeverino D., Roche N., Samolinski B., Shamji MH., Sheikh A., Ulrik CS., Usmani OS., Valiulis A., Yorgancioglu A., Zuberbier T., Fonseca JA., Pétré B., Louis R., Bousquet J., MASK‐air think tank None.
RationaleIt 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.