TY - JOUR
T1 - Classifying asthma severity in children
T2 - Mismatch between symptoms, medication use, and lung function
AU - Bacharier, Leonard B.
AU - Strunk, Robert C.
AU - Mauger, David
AU - White, Deborah
AU - Lemanske, Robert F.
AU - Sorkness, Christine A.
PY - 2004/8/15
Y1 - 2004/8/15
N2 - Current guidelines for asthma care categorize asthma severity based on the frequency of asthma symptoms, medication use, and lung function measures. The objective of this study was to determine whether lung function measures are consistent with levels of asthma severity as defined by the National Asthma Education and Prevention Program/Expert Panel Report 2 Guidelines. Parents of children aged 5-18 years with asthma seen in two outpatient subspecialty clinics completed questionnaires regarding asthma medication use and symptom frequency over the preceding 1 and 4 weeks, respectively. All children performed spirometry. When asthma severity was based on the higher severity of asthma symptom frequency or medication use, asthma was mild intermittent in 6.9% of participants, mild persistent in 27.9%, moderate persistent in 22.4%, and severe persistent in 42.9%. FEV1 % predicted did not differ by level of asthma severity. FEV1/FVC decreased as asthma severity increased (p < 0.0001) and was abnormal in 33% of the participants, and a greater percentage of participants had an abnormal FEV1/FVC as asthma severity increased (p = 0.0001). In children, asthma severity classified by symptom frequency and medication usage does not correlate with FEV1 categories defined by National Asthma Education and Prevention Program Guidelines. FEV1 is generally normal, even in severe persistent childhood asthma, whereas FEV1/FVC declines as asthma severity increases.
AB - Current guidelines for asthma care categorize asthma severity based on the frequency of asthma symptoms, medication use, and lung function measures. The objective of this study was to determine whether lung function measures are consistent with levels of asthma severity as defined by the National Asthma Education and Prevention Program/Expert Panel Report 2 Guidelines. Parents of children aged 5-18 years with asthma seen in two outpatient subspecialty clinics completed questionnaires regarding asthma medication use and symptom frequency over the preceding 1 and 4 weeks, respectively. All children performed spirometry. When asthma severity was based on the higher severity of asthma symptom frequency or medication use, asthma was mild intermittent in 6.9% of participants, mild persistent in 27.9%, moderate persistent in 22.4%, and severe persistent in 42.9%. FEV1 % predicted did not differ by level of asthma severity. FEV1/FVC decreased as asthma severity increased (p < 0.0001) and was abnormal in 33% of the participants, and a greater percentage of participants had an abnormal FEV1/FVC as asthma severity increased (p = 0.0001). In children, asthma severity classified by symptom frequency and medication usage does not correlate with FEV1 categories defined by National Asthma Education and Prevention Program Guidelines. FEV1 is generally normal, even in severe persistent childhood asthma, whereas FEV1/FVC declines as asthma severity increases.
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U2 - 10.1164/rccm.200308-1178OC
DO - 10.1164/rccm.200308-1178OC
M3 - Article
C2 - 15172893
AN - SCOPUS:4544317118
SN - 1073-449X
VL - 170
SP - 426
EP - 432
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 4
ER -