title: Temporal asthma patterns using repeated questionnaires over 13 years in a large French cohort of women.
abstract: Variable expression is one aspect of the heterogeneity of asthma. We aimed to define a variable pattern, which is relevant in general health epidemiological cohorts. Our objectives were to assess whether: 1) asthma patterns defined using simple asthma questions through repeated measurements could reflect disease variability 2) these patterns may further be classified according to asthma severity/control. Among 70,428 French women, we used seven questionnaires (1992-2005) and a comprehensive reimbursement database (2004-2009) to define three reliable asthma patterns based on repeated positive answers to the ever asthma attack question: "never asthma" (n = 64,061); "inconsistent" ("yes" followed by "no", n = 3,514); "consistent" (fully consistent positive answers, n = 2,853). The "Inconsistent" pattern was related to both long-term (childhood-onset asthma with remission in adulthood) and short-term (reported asthma attack in the last 12 months, associated with asthma medication) asthma variability, showing that repeated questions are relevant markers of the variable expression of asthma. Furthermore, in this pattern, the number of positive responses (1992-2005) predicted asthma drug consumption in subsequent years, a marker of disease severity. The "Inconsistent" pattern is a phenotype that may capture the variable expression of asthma. Repeated answers, even to a simple question, are too often neglected.
authors.affiliation: Inserm, CESP Centre for research in Epidemiology and Population Health, U1018, Respiratory and environmental epidemiology Team, F-94807, Villejuif, France. margaux.sanchez@inserm.fr
authors.forename: Margaux
authors.initials: M
authors.lastname: Sanchez
authors.forename: Jean
authors.initials: J
authors.lastname: Bousquet
authors.forename: Nicole
authors.initials: N
authors.lastname: Le Moual
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Jacquemin
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
authors.forename: Francine
authors.initials: F
authors.lastname: Kauffmann
authors.forename: Pascale
authors.initials: P
authors.lastname: Tubert-Bitter
authors.forename: Raphaëlle
authors.initials: R
authors.lastname: Varraso
mesh_terms: D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents