title: Assessment of asthma severity in adults with asthma treated by family practitioners, allergists, and pulmonologists.
abstract: OBJECTIVE
  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, SF-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.
authors.affiliation: Department of Medicine, University of California San Francisco, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Eisner
authors.forename: P P
authors.initials: PP
authors.lastname: Katz
authors.forename: E H
authors.initials: EH
authors.lastname: Yelin
authors.forename: J
authors.initials: J
authors.lastname: Henke
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.forename: P D
authors.initials: PD
authors.lastname: Blanc
mesh_terms: D000293:Adolescent; D000328:Adult; D000486:Allergy and Immunology / Q000706:statistics & numerical data*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000145:classification* / Q000175:diagnosis / Q000534:rehabilitation*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D015272:Pulmonary Medicine / Q000706:statistics & numerical data*; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States
chemical_list: D018927:Anti-Asthmatic Agents