Boer et al reported a model for predicting the risk of severe asthma for a patient with asthma based on clinical parameters and early treatment response. This can help to identify a patient who may benefit from more aggressive management. The authors are from Leiden University, Radboud University and the Academic Medical Centre in The Netherlands.
Patient selection: asthma
Outcome: severe exacerbation or uncontrolled asthma
Parameters:
(1) sex
(2) current smoker
(3) history of exacerbation(s) in the previous year at baseline
(4) Asthma Control Questionnaire (ACQ) score at baseline
(5) number of exacerbation(s) in previous 3 months at follow-up
(6) Asthma Control Questionnaire (ACQ) score at follow-up
Parameter
Finding
beta coefficient
Points
sex
male
0
0
female
0.719
1
current smoker
no
0
0
yes
0.247
1
exacerbations in previous year
no
0
0
yes
0.887
2
ACQ baseline
< 0.75
0.471 * 0.37
0
0.75 to 1.5
0.471 * 1.13
1
> 1.5
0.471 * 2.5
2
exacerbations past 3 months
no
0
0
yes
1.878
4
ACQ follow-up
< 0.75
1.314 * 0.37
0
0.75 to 1.5
1.314 * 1.13
2
> 1.5
1.314 * 2.5
6
total score =
= SUM(points for all 6 parameters)
X =
= SUM(beta-coefficients for all parameters) - 3.714
probability of severe asthma =
= 1 / (1+EXP((-1)* X))
Interpretation:
• minimum score: 0
• maximum score: 16
Score
Risk Group
Absolute Risk
0 to 4
low
0.089, 0.117
5 to 8
intermediate
0.466, 0.47
9 to 16
high
0.644, 0.727
from Table E2 and abstract
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