title: Breathlessness perception assessed by visual analogue scale and lung function in children with asthma: a real-life study.
abstract: BACKGROUND
  In children with asthma, discrepancies between objective indicators of airway obstruction and symptom perception are often observed. Although visual analogue scale (VAS) has been proposed as a useful tool for assessing accurate symptom perception, previous studies conducted in children with asthma included only small cohorts. A study was therefore designed to investigate the usefulness of VAS in establishing a reliable relationship between breathlessness perception and lung function in a large cohort of children with clinical diagnosis of asthma.
  
  
  METHODS
  A total of 703 children [470 boys and 233 girls, median age 10.29 (8.33-12.58) yr] with asthma were included in this cross-sectional, real-life study. Perception of breathlessness was assessed by using VAS, and lung volumes and expiratory flows were measured by spirometry.
  
  
  RESULTS
  Most children had intermittent or mild persistent asthma (93.3%), and only 46 children had a significant bronchial obstruction defined by FEV(1) values <80% of predicted. Globally, VAS was significantly, even though weakly, related to lung function. Analyzing children with bronchial obstruction, a moderate relationship between both FEV(1) (r = 0.47) and FEF(25-75) (r = 0.42) and VAS was detected. A VAS value of 6 was found to be a reliable cutoff for discriminating children with bronchial obstruction (AUC 0.83 at ROC curve; OR 9.4).
  
  
  CONCLUSIONS
  The present study demonstrates that VAS might be considered a useful tool to assess symptom perception, mainly in children with airflow limitation.
authors.affiliation: Pediatric Pulmonology and Allergy Unit, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Tosca
authors.forename: Michela
authors.initials: M
authors.lastname: Silvestri
authors.forename: Roberta
authors.initials: R
authors.lastname: Olcese
authors.forename: Angela
authors.initials: A
authors.lastname: Pistorio
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Rossi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D010465:Perception; D012372:ROC Curve; D012129:Respiratory Function Tests; D012720:Severity of Illness Index