Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study
Summary: 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 deve...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-04-01
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| Series: | The Lancet: Digital Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589750023000201 |
| _version_ | 1827980687941042176 |
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| author | Bernardo Sousa-Pinto, PhD Cristina Jácome, PhD Ana Margarida Pereira, MD Frederico S Regateiro, MD Rute Almeida, PhD Wienczyslawa Czarlewski, MD Marek Kulus, ProfMD Mohamed H Shamji, ProfMD Louis-Philippe Boulet, ProfMD Matteo Bonini, MD Luisa Brussino, MD G Walter Canonica, ProfMD Alvaro A Cruz, MD Bilun Gemicioglu, ProfMD Tari Haahtela, ProfMD Maciej Kupczyk, MD Violeta Kvedariene, MD Desirée Larenas-Linnemann, MD Renaud Louis, ProfMD Marek Niedoszytko, ProfMD Nhân Pham-Thi, MD Francesca Puggioni, MD Jan Romantowski, MD Joaquin Sastre, ProfMD Nicola Scichilone, ProfMD Luis Taborda-Barata, ProfMD Maria Teresa Ventura, MD Rafael José Vieira, MD Ioana Agache, ProfMD Anna Bedbrook, BSc Karl C Bergmann, MD Rita Amaral, PhD Luís Filipe Azevedo, PhD Sinthia Bosnic-Anticevich, ProfPhD Guy Brusselle, ProfMD Roland Buhl, ProfMD Lorenzo Cecchi, MD Denis Charpin, MD Claudia Chaves Loureiro, MD Frédéric de Blay, ProfMD Stefano Del Giacco, ProfMD Philippe Devillier, ProfMD Ewa Jassem, ProfMD Guy Joos, ProfMD Marek Jutel, ProfMD Ludger Klimek, MD Piotr Kuna, ProfMD Daniel Laune, PhD Jorge Luna Pech, MD Mika Makela, ProfMD Mario Morais-Almeida, MD Rachel Nadif, PhD Hugo E Neffen, MD Ken Ohta, ProfMD Nikolaos G Papadopoulos, ProfMD Alberto Papi, ProfMD Benoit Pétré, MD Oliver Pfaar, MD Daniela Rivero Yeverino, MD Carlos Robalo Cordeiro, ProfMD Nicolas Roche, ProfMD Ana Sá-Sousa, PhD Boleslaw Samolinski, ProfMD Aziz Sheikh, ProfMD Charlotte Suppli Ulrik, ProfMD Omar S Usmani, ProfMD Arunas Valiulis, ProfMD Olivier Vandenplas, ProfMD Pedro Vieira-Marques, PhD Arzu Yorgancioglu, ProfMD Torsten Zuberbier, ProfMD Josep M Anto, ProfMD João A Fonseca, PhD Jean Bousquet, ProfMD |
| author_facet | Bernardo Sousa-Pinto, PhD Cristina Jácome, PhD Ana Margarida Pereira, MD Frederico S Regateiro, MD Rute Almeida, PhD Wienczyslawa Czarlewski, MD Marek Kulus, ProfMD Mohamed H Shamji, ProfMD Louis-Philippe Boulet, ProfMD Matteo Bonini, MD Luisa Brussino, MD G Walter Canonica, ProfMD Alvaro A Cruz, MD Bilun Gemicioglu, ProfMD Tari Haahtela, ProfMD Maciej Kupczyk, MD Violeta Kvedariene, MD Desirée Larenas-Linnemann, MD Renaud Louis, ProfMD Marek Niedoszytko, ProfMD Nhân Pham-Thi, MD Francesca Puggioni, MD Jan Romantowski, MD Joaquin Sastre, ProfMD Nicola Scichilone, ProfMD Luis Taborda-Barata, ProfMD Maria Teresa Ventura, MD Rafael José Vieira, MD Ioana Agache, ProfMD Anna Bedbrook, BSc Karl C Bergmann, MD Rita Amaral, PhD Luís Filipe Azevedo, PhD Sinthia Bosnic-Anticevich, ProfPhD Guy Brusselle, ProfMD Roland Buhl, ProfMD Lorenzo Cecchi, MD Denis Charpin, MD Claudia Chaves Loureiro, MD Frédéric de Blay, ProfMD Stefano Del Giacco, ProfMD Philippe Devillier, ProfMD Ewa Jassem, ProfMD Guy Joos, ProfMD Marek Jutel, ProfMD Ludger Klimek, MD Piotr Kuna, ProfMD Daniel Laune, PhD Jorge Luna Pech, MD Mika Makela, ProfMD Mario Morais-Almeida, MD Rachel Nadif, PhD Hugo E Neffen, MD Ken Ohta, ProfMD Nikolaos G Papadopoulos, ProfMD Alberto Papi, ProfMD Benoit Pétré, MD Oliver Pfaar, MD Daniela Rivero Yeverino, MD Carlos Robalo Cordeiro, ProfMD Nicolas Roche, ProfMD Ana Sá-Sousa, PhD Boleslaw Samolinski, ProfMD Aziz Sheikh, ProfMD Charlotte Suppli Ulrik, ProfMD Omar S Usmani, ProfMD Arunas Valiulis, ProfMD Olivier Vandenplas, ProfMD Pedro Vieira-Marques, PhD Arzu Yorgancioglu, ProfMD Torsten Zuberbier, ProfMD Josep M Anto, ProfMD João A Fonseca, PhD Jean Bousquet, ProfMD |
| author_sort | Bernardo Sousa-Pinto, PhD |
| collection | DOAJ |
| description | Summary: 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. |
| first_indexed | 2024-04-09T21:56:19Z |
| format | Article |
| id | doaj.art-56dce9f1f5fa4cbca1e55bfb1691b095 |
| institution | Directory Open Access Journal |
| issn | 2589-7500 |
| language | English |
| last_indexed | 2024-04-09T21:56:19Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet: Digital Health |
| spelling | doaj.art-56dce9f1f5fa4cbca1e55bfb1691b0952023-03-24T04:23:20ZengElsevierThe Lancet: Digital Health2589-75002023-04-0154e227e238Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data studyBernardo Sousa-Pinto, PhD0Cristina Jácome, PhD1Ana Margarida Pereira, MD2Frederico S Regateiro, MD3Rute Almeida, PhD4Wienczyslawa Czarlewski, MD5Marek Kulus, ProfMD6Mohamed H Shamji, ProfMD7Louis-Philippe Boulet, ProfMD8Matteo Bonini, MD9Luisa Brussino, MD10G Walter Canonica, ProfMD11Alvaro A Cruz, MD12Bilun Gemicioglu, ProfMD13Tari Haahtela, ProfMD14Maciej Kupczyk, MD15Violeta Kvedariene, MD16Desirée Larenas-Linnemann, MD17Renaud Louis, ProfMD18Marek Niedoszytko, ProfMD19Nhân Pham-Thi, MD20Francesca Puggioni, MD21Jan Romantowski, MD22Joaquin Sastre, ProfMD23Nicola Scichilone, ProfMD24Luis Taborda-Barata, ProfMD25Maria Teresa Ventura, MD26Rafael José Vieira, MD27Ioana Agache, ProfMD28Anna Bedbrook, BSc29Karl C Bergmann, MD30Rita Amaral, PhD31Luís Filipe Azevedo, PhD32Sinthia Bosnic-Anticevich, ProfPhD33Guy Brusselle, ProfMD34Roland Buhl, ProfMD35Lorenzo Cecchi, MD36Denis Charpin, MD37Claudia Chaves Loureiro, MD38Frédéric de Blay, ProfMD39Stefano Del Giacco, ProfMD40Philippe Devillier, ProfMD41Ewa Jassem, ProfMD42Guy Joos, ProfMD43Marek Jutel, ProfMD44Ludger Klimek, MD45Piotr Kuna, ProfMD46Daniel Laune, PhD47Jorge Luna Pech, MD48Mika Makela, ProfMD49Mario Morais-Almeida, MD50Rachel Nadif, PhD51Hugo E Neffen, MD52Ken Ohta, ProfMD53Nikolaos G Papadopoulos, ProfMD54Alberto Papi, ProfMD55Benoit Pétré, MD56Oliver Pfaar, MD57Daniela Rivero Yeverino, MD58Carlos Robalo Cordeiro, ProfMD59Nicolas Roche, ProfMD60Ana Sá-Sousa, PhD61Boleslaw Samolinski, ProfMD62Aziz Sheikh, ProfMD63Charlotte Suppli Ulrik, ProfMD64Omar S Usmani, ProfMD65Arunas Valiulis, ProfMD66Olivier Vandenplas, ProfMD67Pedro Vieira-Marques, PhD68Arzu Yorgancioglu, ProfMD69Torsten Zuberbier, ProfMD70Josep M Anto, ProfMD71João A Fonseca, PhD72Jean Bousquet, ProfMD73MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, PortugalMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, PortugalMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal; Patient Centred Innovation and Technology, Centro de Investigação em Tecnologias e Serviços de Saúde, Centre for Health Technology and Services Research, University of Porto, Porto, PortugalAllergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra and Institute of Immunology, and Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, PortugalMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, PortugalMedical Consulting Czarlewski, Levallois, FranceDepartment of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, PolandNational Heart and Lung Institute, Imperial College & National Institutes for Health Imperial Biomedical Research Centre, London, UKQuebec Heart and Lung Institute, Laval University, Québec City, Quebec, CanadaDepartment of Cardiovascular and Respiratory Sciences, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Neurological, Ear, Nose, and Throat, and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; National Heart and Lung Institute, Imperial College London, London, UKDepartment of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, ItalyFundaçao ProAR, Federal University of Bahia and Global Alliance Against Chronic Respiratory Diseases and WHO Planning Group, Salvador, Bahia, BrazilDepartment of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TürkiyeSkin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, FinlandDivision of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, PolandInstitute of Biomedical Sciences, Department of Pathology and Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, LithuaniaCenter of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, MexicoDepartment of Pulmonary Medicine, Centre Hospitalier Universitaire Liege, and GIGA Infection, Immunity, Inflammation Laboratories research group, University of Liege, Liege, BelgiumDepartment of Allergology, Medical University of Gdańsk, Gdansk, PolandInstitut de Recherche bio-Médicale des Armées, Bretigny sur Orge, France; École Polytechnique de Palaiseau, Palaiseau, France; Université Paris Cité, Paris, FrancePersonalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, ItalyDepartment of Allergology, Medical University of Gdańsk, Gdansk, PolandAllergy Service, Fundacion Jimenez Diaz, Faculty of Medicine Universidad Autonoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, SpainPROMISE Department, University of Palermo, Palermo, ItalyUniversity of Beira Interior Air, Clinical & Experimental Lung Centre and Centro de Investigação em Ciências da Saúde-University of Beira Interior Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, PortugalUnit of Geriatric Immunoallergology, University of Bari Medical School, Bari, ItalyMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, PortugalFaculty of Medicine, Transylvania University Brasov, Brasov, RomaniaAllergic Rhinitis and its Impact on Asthma, Montpellier, FranceInstitute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, GermanyMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, PortugalMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, PortugalQuality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, The University of Sydney, and Sydney Local Health District, Sydney, NSW, AustraliaDepartment of Respiratory Medicine, Ghent University Hospital, Ghent, BelgiumDepartment of Pulmonary Medicine, Mainz University Hospital, Mainz, GermanyStruttura Organizzativa Semplice Allergology and Clinical Immunology Unita Sanitaria Locale, Toscana Centro, Prato, ItalyClinique des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, FrancePneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalAllergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France; Federation of Translational Medicine, University of Strasbourg, Strasbourg, FranceDepartment of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital Duilio Casula, University of Cagliari, Cagliari, ItalyVirologie et Immunologie Moléculaires Suresnes, Unités Mixtes de Recherche 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, FranceMedical University of Gdańsk, Department of Pneumonology, Gdansk, PolandDepartment of Respiratory Medicine, Ghent University Hospital, Ghent, BelgiumDepartment of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland; All-Medicine Medical Research Institute, Wroclaw, PolandDepartment of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, GermanyDivision of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, PolandKYomed Innovation, Montpellier, FranceUniversity of Guadalajara, Guadalajara, MexicoSkin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, FinlandAllergy Center, Companhia União Fabril Descobertas Hospital, Lisbon, PortugalUniversité Paris-Saclay, Université Versailles-St Quentin, Université Paris-Sud, Paris, France; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, Villejuif, FranceCenter of Allergy, Immunology and Respiratory Diseases, Santa Fe, ArgentinaNational Hospital Organization, Tokyo National Hospital, Tokyo, Japan; JATA Fukujuji Hospital, Tokyo, JapanAllergy Department, 2nd Pediatric Clinic, University of Athens, Athens, GreeceRespiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, ItalyDepartment of Public Health, University of Liege, Liege, BelgiumSection of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, GermanyAllergy and Clinical Immunology Department, Hospital Universitario de Puebla, Puebla, MexicoDepartment of Pneumology, Coimbra University Hospital, Coimbra, PortugalPneumologie, Assistance Publique - Hôpitaux de Paris, Centre Université de Paris Cité, Hôpital Cochin, Paris, FranceMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal; Patient Centred Innovation and Technology, Centro de Investigação em Tecnologias e Serviços de Saúde, Centre for Health Technology and Services Research, University of Porto, Porto, PortugalDepartment of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, PolandUsher Institute, The University of Edinburgh, Edinburgh, UKDepartment of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkNational Heart and Lung Institute, Imperial College London, London, UK; Royal Brompton Hospital, Airways Disease Section, London, UKInstitute of Clinical Medicine and Institute of Health Sciences and Medical Faculty of Vilnius University, Vilnius, LithuaniaDepartment of Chest Medicine, Centre Hospitalier Universitaire UCL, Namur, Belgium; Université Catholique de Louvain, Yvoir, BelgiumMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, TürkiyeInstitute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, GermanyISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, SpainMEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, PortugalInstitute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, Villejuif, France; University Hospital Montpellier, Montpellier, France; Correspondence to: Professor Jean Bousquet, Institute of Allergology Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanySummary: 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.http://www.sciencedirect.com/science/article/pii/S2589750023000201 |
| spellingShingle | Bernardo Sousa-Pinto, PhD Cristina Jácome, PhD Ana Margarida Pereira, MD Frederico S Regateiro, MD Rute Almeida, PhD Wienczyslawa Czarlewski, MD Marek Kulus, ProfMD Mohamed H Shamji, ProfMD Louis-Philippe Boulet, ProfMD Matteo Bonini, MD Luisa Brussino, MD G Walter Canonica, ProfMD Alvaro A Cruz, MD Bilun Gemicioglu, ProfMD Tari Haahtela, ProfMD Maciej Kupczyk, MD Violeta Kvedariene, MD Desirée Larenas-Linnemann, MD Renaud Louis, ProfMD Marek Niedoszytko, ProfMD Nhân Pham-Thi, MD Francesca Puggioni, MD Jan Romantowski, MD Joaquin Sastre, ProfMD Nicola Scichilone, ProfMD Luis Taborda-Barata, ProfMD Maria Teresa Ventura, MD Rafael José Vieira, MD Ioana Agache, ProfMD Anna Bedbrook, BSc Karl C Bergmann, MD Rita Amaral, PhD Luís Filipe Azevedo, PhD Sinthia Bosnic-Anticevich, ProfPhD Guy Brusselle, ProfMD Roland Buhl, ProfMD Lorenzo Cecchi, MD Denis Charpin, MD Claudia Chaves Loureiro, MD Frédéric de Blay, ProfMD Stefano Del Giacco, ProfMD Philippe Devillier, ProfMD Ewa Jassem, ProfMD Guy Joos, ProfMD Marek Jutel, ProfMD Ludger Klimek, MD Piotr Kuna, ProfMD Daniel Laune, PhD Jorge Luna Pech, MD Mika Makela, ProfMD Mario Morais-Almeida, MD Rachel Nadif, PhD Hugo E Neffen, MD Ken Ohta, ProfMD Nikolaos G Papadopoulos, ProfMD Alberto Papi, ProfMD Benoit Pétré, MD Oliver Pfaar, MD Daniela Rivero Yeverino, MD Carlos Robalo Cordeiro, ProfMD Nicolas Roche, ProfMD Ana Sá-Sousa, PhD Boleslaw Samolinski, ProfMD Aziz Sheikh, ProfMD Charlotte Suppli Ulrik, ProfMD Omar S Usmani, ProfMD Arunas Valiulis, ProfMD Olivier Vandenplas, ProfMD Pedro Vieira-Marques, PhD Arzu Yorgancioglu, ProfMD Torsten Zuberbier, ProfMD Josep M Anto, ProfMD João A Fonseca, PhD Jean Bousquet, ProfMD Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study The Lancet: Digital Health |
| title | Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study |
| title_full | Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study |
| title_fullStr | Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study |
| title_full_unstemmed | Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study |
| title_short | Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study |
| title_sort | development and validation of an electronic daily control score for asthma e dasthma a real world direct patient data study |
| url | http://www.sciencedirect.com/science/article/pii/S2589750023000201 |
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