title: Sex differences in asthma symptom profiles and control in the American Lung Association Asthma Clinical Research Centers.
abstract: OBJECTIVE
  Important differences between men and women with asthma have been demonstrated, with women describing more symptoms and worse asthma-related quality of life (QOL) despite having similar or better pulmonary function. While current guidelines focus heavily on assessing asthma control, they lack information about whether sex-specific approaches to asthma assessment should be considered. We sought to determine if sex differences in asthma control or symptom profiles exist in the well-characterized population of participants in the American Lung Association Asthma Clinical Research Centers (ALA-ACRC) trials.
  
  
  METHODS
  We reviewed baseline data from four trials published by the ALA-ACRC to evaluate individual item responses to three standardized asthma questionnaires: the Juniper Asthma Control Questionnaire (ACQ), the multi-attribute Asthma Symptom Utility Index (ASUI), and Juniper Mini Asthma Quality of Life Questionnaire (mini-AQLQ).
  
  
  RESULTS
  In the poorly-controlled population, women reported similar overall asthma control (mean ACQ 1.9 vs. 1.8; p = 0.54), but were more likely to report specific symptoms such as nocturnal awakenings, activity limitations, and shortness of breath on individual item responses. Women reported worse asthma-related QOL on the mini-AQLQ (mean 4.5 vs. 4.9; p < 0.001) and more asthma-related symptoms with a lower mean score on the ASUI (0.73 vs. 0.77; p ≤ 0.0001) and were more likely to report feeling bothered by particular symptoms such as coughing, or environmental triggers.
  
  
  CONCLUSIONS
  In participants with poorly-controlled asthma, women had outwardly similar asthma control, but had unique symptom profiles on detailed item analyses which were evident on evaluation of three standardized asthma questionnaires.
authors: Wexner Medical Center at The Ohio State University, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, 201 Davis Heart & Lung Research Institute, 473 W. 12th Avenue, Columbus, OH 43210, USA. Electronic address: Jennifer.McCallister@osumc.edu.
authors: Jennifer W
authors: JW
authors: McCallister
authors: Janet T
authors: JT
authors: Holbrook
authors: Christine Y
authors: CY
authors: Wei
authors: Jonathan P
authors: JP
authors: Parsons
authors: Cathy G
authors: CG
authors: Benninger
authors: Anne E
authors: AE
authors: Dixon
authors: Lynn B
authors: LB
authors: Gerald
authors: John G
authors: JG
authors: Mastronarde
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D001294:Attitude to Health; D003371:Cough / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012131:Respiratory Insufficiency / Q000209:etiology; D012727:Sex Characteristics; D012893:Sleep Wake Disorders / Q000209:etiology; D011795:Surveys and Questionnaires; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents
keywords: ACQ; ALA-ACRC; ASUI; ATAQ; American Lung Association Asthma Clinical Research Centers; Asthma; Asthma Control Questionnaire; Asthma Symptom Utility Index; Asthma Therapy Assessment Questionnaire; BMI; Control; Effectiveness of Low Dose Theophylline as Add-On Therapy In Treatment of Asthma; FEV(1); GERD; LOCCS; LODO; MID; PC(20); QOL; SABA; SARA; Sex differences; Study of Acid Reflux and Asthma; Symptom profiles; TAPE; Trial of Asthma Patient Education; body mass index; forced expiratory volume in one second; gastroesophageal reflux disease; leukotriene or corticosteroid or corticosteroid–salmeterol trial; mini asthma quality of life questionnaire; mini-AQLQ; minimal clinically important difference; provocative concentration of methacholine; quality of life; short-acting beta-agonist
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