Asthma phenotypes in inner-city children

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Presentation transcript:

Asthma phenotypes in inner-city children Edward M. Zoratti, MD, Rebecca Z. Krouse, MS, Denise C. Babineau, PhD, MS, Jacqueline A. Pongracic, MD, George T. O'Connor, MD, MS, Robert A. Wood, MD, Gurjit K. Khurana Hershey, MD, PhD, Carolyn M. Kercsmar, MD, Rebecca S. Gruchalla, MD, PhD, Meyer Kattan, MD, Stephen J. Teach, MD, MPH, Steven M. Sigelman, RN, MHA, Peter J. Gergen, MD, MPH, Alkis Togias, MD, Cynthia M. Visness, PhD, William W. Busse, MD, Andrew H. Liu, MD Journal of Allergy and Clinical Immunology Volume 138, Issue 4, Pages 1016-1029 (October 2016) DOI: 10.1016/j.jaci.2016.06.061 Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10 Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10.1016/j.jaci.2016.06.061) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Dendrogram produced by the HCA. Participants in clusters A, B, C, D, and E are denoted by the colors red, blue, green, purple, and orange, respectively. The y-axis is a measure of dissimilarity between clusters such that the greater the height at which 2 clusters break off from one another, the greater the dissimilarity between the 2 clusters. The gray line indicates the height of the 5-cluster solution, as it cuts through 5 vertical lines, each of which represents a cluster. Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10.1016/j.jaci.2016.06.061) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Variable importance plot of characteristics distinguishing the clusters. Bars plot the median z score for each variable, a measure of importance obtained from a feature selection algorithm called Boruta where higher values indicate a higher level of importance. Only those variables that were confirmed as relevant to distinguishing between the 5 clusters are presented in this figure. ACT/cACT, Asthma Control Test/Childhood Asthma Control Test; CASI, Composite Asthma Severity Index. Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10.1016/j.jaci.2016.06.061) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Descriptive summary indicating the relative degree to which asthma, pulmonary physiology, rhinitis, and allergy-related variables were present in each cluster. The graded color scheme contains 5 shades of blue, representing the 20th (lightest), 40th, 60th, 80th, and 100th (darkest) percentiles of the data for each row. Overall P values indicating differences between the 5 clusters are P < .0001 for all variables. Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10.1016/j.jaci.2016.06.061) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Characteristics related to allergy by cluster. Categorical variables are summarized by bar charts with whiskers for standard errors. Continuous variables are summarized by notched boxplots, such that the box represents the interquartile range, the whiskers add/subtract 1.5 times the 75th/25th percentiles, the line represents the median, and the notch represents the 95% CI around the median. For continuous variables, the mean number of allergen sensitizations or geometric mean of total serum IgE is represented by the black dot. Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10.1016/j.jaci.2016.06.061) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Characteristics of pulmonary physiology and inflammatory biomarkers by cluster. Categorical variables are summarized by barcharts with whiskers for standard errors. Continuous variables are summarized by notched boxplots, such that the box represents the interquartile range, the whiskers add/subtract 1.5 times the 75th/25th percentiles, the line represents the median, and the notch represents the 95% CI around the median. For continuous variables, mean FEV1/FVC (×100) or geometric mean Feno is represented by the black dot, with the exception of blood eosinophils and PC20, where median value is most appropriate. CASI, Composite Asthma Severity Index. Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10.1016/j.jaci.2016.06.061) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Characteristics of asthma symptoms, exacerbations, and treatment by cluster. Categorical variables are summarized by bar charts with whiskers for standard errors. Continuous variables are summarized by notched boxplots, such that the box represents the interquartile range, the whiskers add/subtract 1.5 times the 75th/25th percentiles, the line represents the median, and the notch represents the 95% CI around the median. For continuous variables, the black dot indicates the mean value. Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10.1016/j.jaci.2016.06.061) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 7 Characteristics of rhinitis by cluster. Categorical variables are summarized by bar charts with whiskers for standard errors. Continuous variables are summarized by notched boxplots, such that the box represents the interquartile range, the whiskers add/subtract 1.5 times the 75th/25th percentiles, the line represents the median, and the notch represents the 95% CI around the median. For rhinitis symptom score, the black dot indicates the mean value. A detailed algorithm describing rhinitis medication management during the APIC study can be found in Pongracic et al.12 ACT/cACT, Asthma Control Test/Childhood Asthma Control Test; CASI, Composite Asthma Severity Index. Journal of Allergy and Clinical Immunology 2016 138, 1016-1029DOI: (10.1016/j.jaci.2016.06.061) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions