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Validation of the Adult Asthma Epidemiological Score: a secondary analysis of EPI-ASTHMA

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Abstract(s)

The A2 score is an 8-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. This accuracy study is a secondary analysis of the EPI-ASTHMA population-based study. Random adult participants recruited from primary healthcare centers in Portugal were analyzed. Participants answered the A2 score by telephone interview. 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. A total of 1283 participants (median 54[p25-p75 43-66] years; 60% female) were analyzed. The A2 score showed high discriminatory power in identifying asthma, with an area under the ROC curve of 82.9(95%CI 80.4-85.4)%. 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%). The A2 score is a useful tool to identify patients with asthma in a primary care population.

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Keywords

Asthma Epidemiology Diagnostic screening Patient-reported outcome measure

Citation

Laranjeira, C., Jácome, C., Amaral, R., Bernardo, F., Sousa, J. C., & Fonseca. (2024). Validation of the Adult Asthma Epidemiological Score: A secondary analysis of EPI-ASTHMA. Livro de Resumos do 17º Encontro de Investigação Jovem da U.Porto / Book of Abstracts Young Researchers Meeting of U.Porto, 1124. https://www.up.pt/ijup/wp-content/uploads/sites/892/2024/05/Livro-de-Resumos_final.pdf

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Universidade do Porto

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