Validation of a single survey that can be used for case identification and assessment of asthma control: the Breathmobile Program.
BACKGROUND
Underdiagnosis of asthma and underrecognition of disease severity in lower socioeconomic populations continue to be significant health care concerns despite national efforts to better educate health care providers.


OBJECTIVE
To validate a 1-page survey as a point-in-time tool identifying uncontrolled vs controlled asthma and moderate-to-severe disease activity in an urban, lower-socioeconomic pediatric population.


METHODS
A previously validated survey (the Breathmobile Case Identification Survey) was evaluated as a point-in-time tool for identifying children with poorly controlled disease. Clinical validation was achieved in children (n = 1,826) presenting to a school-based asthma program for either an initial (n = 666) or a follow-up (n = 1,170) visit. Responses were compared with a comprehensive evaluation by a physician specialist as the gold standard. Response patterns were used to construct multimodel tiered scoring algorithms for baseline and follow-up visits that identify children with uncontrolled asthma, and children are likely to have moderate-to-severe disease activity at that time.


RESULTS
Surveys scored using the developed algorithms identified children with uncontrolled asthma (sensitivity: baseline, 77.0%; follow-up, 71.6%; specificity: baseline, 72.7%; follow-up, 71.5%) and detected moderate-to-severe disease activity (sensitivity: baseline, 69.2%; follow-up, 77.4%; specificity: baseline, 70.2%; follow-up, 70.3%).


CONCLUSIONS
The Breathmobile Case Identification Survey can be used in lower-socioeconomic, urban populations as a point-in-time tool for identifying children with uncontrolled vs controlled asthma and moderate-to-severe disease activity.
Kachru
Rita
R
Division of Allergy and Immunology, Department of Pediatrics, Los Angeles County + University of Southern California Medical Center, Los Angeles, California 90033, USA.
Morphew
Tricia
T
Kehl
Sarah
S
Clement
Loran T
LT
Hanley-Lopez
Jean
J
Kwong
Kenny Y C
KY
Guterman
Jeffrey J
JJ
Jones
Craig A
CA
D000293:Adolescent; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D012959:Socioeconomic Factors