Assessment of asthma severity in adults with asthma treated by family practitioners, allergists, and pulmonologists
Assessment of asthma severity in adults with asthma treated by family practitioners, allergists, and pulmonologists
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DOI：
10.1097/00005650-199811000-00006
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发表时间：
1998-11-01
期刊：
影响因子：
3
通讯作者：
Blanc, PD
中科院分区：
文献类型：
--
作者：
Eisner, MD;Katz, PP;Blanc, PD
目标.准确测量哮喘严重程度对于评估哮喘健康结果的研究至关重要。然而，没有广泛接受的哮喘严重程度测量。基于自我报告信息的哮喘严重程度评分先前已在从肺和过敏专科实践招募的受试者中开发和验证。本研究的目的是验证家庭医生治疗的哮喘严重程度评分，并比较家庭医生治疗的哮喘严重程度（n = 150）与过敏症专家（n = 217）和肺病专家（n = 384）。这项研究是一项正在进行的成人哮喘患者的小组研究。受试者是一个随机样本的董事会认证的家庭执业，过敏，肺科医生。每位医生都登记了18至50岁的哮喘患者。在869名登记的受试者中，751人（86%）完成了结构化电话访谈。家庭医生小组是在专科小组之后大约3年招募的。在家庭医疗受试者中，哮喘严重程度评分表现出内部一致性（Cronbach α 0.76）和并行效度，与哮喘特异性生活质量、SE-36一般健康和身体功能量表以及受试者感知的哮喘严重程度密切相关。在控制人口统计学特征后，5分的增量与急诊科就诊、急诊医生就诊和活动受限天数的增加相关。肺部组的平均严重程度评分最高（11.8 ± 6.3），其次是过敏（10.3 ± 5.3）和家庭实践（9.3 ± 5.5）组。哮喘严重程度评分是全科治疗受试者的有效指标。哮喘的严重程度因医生专业而异。
OBJECTIVES. Accurate measurement of asthma severity is critical for research evaluating asthma health outcomes. There are,however, no widely accepted asthma severity measures. A severity-of-asthma score, which is based on self-reported information was previously developed and validated in subjects recruited from pulmonary and allergy subspecialty practices. The purpose of this study was to validate the severity-of-asthma score in subjects treated by family practice physicians and to compare asthma severity in subjects treated by family practitioners (n = 150) with those seen by allergists (n = 217) and pulmonologists (n = 384).METHODS. The study was an ongoing panel study of adults with asthma. Subjects were a random sample of board-certified family practice, allergy, and pulmonary physicians. Each physician registered patients with asthma aged 18 to 50 years. Of 869 subjects registered, 751 (86%) completed structured telephone interviews. The family practice panel was recruited approximately 3 years after the subspecialty panel.RESULTS. In the family practice subjects, the severity-of-asthma score demonstrated internal consistency (Cronbach's alpha 0.76) and concurrent validity, correlating strongly with asthma-specific quality of life, SE-36 General Health and Physical Functioning scales, and subject-perceived asthma severity. After controlling for demographic characteristics, a 5-point score increment was associated with increased emergency department visits, urgent physician visits, and restricted activity days. The mean severity score was highest in the pulmonary group (11.8 +/- 6.3), followed by the allergy(10.3 +/- 5.3) and family practice (9.3 +/- 5.5) groups.CONCLUSIONS. The severity-of-asthma score was a valid measure in generalist-treated subjects. Asthma severity varied significantly by physician specialty.