Development and Validation of Personalized Prediction to Estimate Future Risk of Severe Exacerbations and Uncontrolled Asthma in Patients with Asthma,

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Presentation transcript:

Development and Validation of Personalized Prediction to Estimate Future Risk of Severe Exacerbations and Uncontrolled Asthma in Patients with Asthma, Using Clinical Parameters and Early Treatment Response Suzanne Boer, MSc, Jacob K. Sont, PhD, Rik J.B. Loijmans, MD, Jiska B. Snoeck-Stroband, MD, PhD, Gerben ter Riet, MD, PhD, Tjard R.J. Schermer, PhD, Willem J.J. Assendelft, MD, PhD, Persijn J. Honkoop, MD, PhD The Journal of Allergy and Clinical Immunology: In Practice Volume 7, Issue 1, Pages 175-182.e5 (January 2019) DOI: 10.1016/j.jaip.2018.06.007 Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Figure 1 Flowchart of inclusion and exclusion of patients with a diagnosis of asthma in the derivation data set. In the validation cohort, only 5 patients were excluded without any measurement at baseline, or at 3 or 12 months of follow-up. The Journal of Allergy and Clinical Immunology: In Practice 2019 7, 175-182.e5DOI: (10.1016/j.jaip.2018.06.007) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Figure 2 The risk prediction score is on the x-axis, and the absolute risk in the data set is on the y-axis: derivation data set (A) and validation data set (B). Circles represent the number of patients; the larger the circle, the more patients with the same risk prediction score. The green area represents the low-risk category (11.7%), followed by the orange intermediate-risk category (47%) and on the right side the high-risk category (72.7%) as the red area. A regression line was fitted; the absolute risk increases with the increasing risk prediction score (derivation data set, 0.0602x – 0.0259; validation data set 0.047x + 0.017). The Journal of Allergy and Clinical Immunology: In Practice 2019 7, 175-182.e5DOI: (10.1016/j.jaip.2018.06.007) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Figure 3 The risk prediction score in clinical practice: simplified users guide. The Journal of Allergy and Clinical Immunology: In Practice 2019 7, 175-182.e5DOI: (10.1016/j.jaip.2018.06.007) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Figure E1 Calibration plots in the derivation data set. The Journal of Allergy and Clinical Immunology: In Practice 2019 7, 175-182.e5DOI: (10.1016/j.jaip.2018.06.007) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Figure E2 AUROC comparing the models with and without early treatment response to the approach of clinical practice (in the derivation data set). The model with early treatment response differs significantly from the model without early treatment response (P < .01) and from the model representing clinical practice approach (P < .001). The Journal of Allergy and Clinical Immunology: In Practice 2019 7, 175-182.e5DOI: (10.1016/j.jaip.2018.06.007) Copyright © 2019 American Academy of Allergy, Asthma & Immunology Terms and Conditions