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Short-Acting β-Agonist Use As a Marker of Current Asthma Control
Mitesh Patel, BMedSci, BMBS, MRCP, Janine Pilcher, BSc, MBChB, Claire Munro, BSc, Alexander Hosking, Alison Pritchard, Dominick Shaw, MBChB, MD, MRCP, Peter Black, MBChB, FRACP, Mark Weatherall, MBChB, FRACP, Richard Beasley, MBChB, DSc The Journal of Allergy and Clinical Immunology: In Practice Volume 1, Issue 4, Pages (July 2013) DOI: /j.jaip Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions
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Figure 1 Scatter plots of asthma symptoms as measured by ACQ-5 score versus metrics of albuterol use that include (A) days of albuterol use, (B) average albuterol use per day, (C) maximum albuterol use in 24-hours, and (D) nocturnal albuterol use. The x-axis is the albuterol use metric. The y-axis is ACQ-5 score (range, 0-6), where a score of ≤0.75 represents well-controlled asthma and a score of ≥1.5 represents not well-controlled asthma. Reference lines are shown at these thresholds. The Journal of Allergy and Clinical Immunology: In Practice 2013 1, DOI: ( /j.jaip ) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions
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Figure 2 Number of days of albuterol use over a 1-week period as a predictor of not well-controlled asthma (ACQ-5 score ≥1.5). A, ROC curve for the number of days of albuterol use over 1 week as a predictor of not well-controlled asthma (ACQ-5 score ≥1.5). Cut points are displayed on the curve. B, Sensitivity (true positive/patients with poorly controlled asthma, defined as ACQ-5 ≥1.5), specificity (true negative/patients who do not have poorly controlled asthma, defined as ACQ-5 <1.5), positive predictive value (true positive/test positive), and negative predictive value (true negative/test negative) for the cut points. The Journal of Allergy and Clinical Immunology: In Practice 2013 1, DOI: ( /j.jaip ) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions
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Figure 3 Average daily use of albuterol over a 1-week period as a predictor of not well-controlled asthma (ACQ-5 score ≥1.5). A, ROC curve for the average number of actuations of albuterol per day over 1 week as a predictor of not well-controlled asthma (ACQ-5 score ≥1.5). Cut points are displayed on the curve. B, Sensitivity (true positive/patients with poorly controlled asthma, defined as ACQ-5 ≥1.5), specificity (true negative/patients who do not have poorly controlled asthma, defined as ACQ-5 <1.5), positive predictive value (true positive/test positive), and negative predictive value (true negative/test negative) for the cut points. The Journal of Allergy and Clinical Immunology: In Practice 2013 1, DOI: ( /j.jaip ) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions
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Figure 4 Highest number of albuterol actuations per day over a 1-week period of observation as a predictor of not well-controlled asthma (ACQ-5 score ≥1.5). A, ROC curve for the highest number of actuations of albuterol per day over 1 week as a predictor of not well-controlled asthma (ACQ-5 score ≥1.5). Cut points are displayed on the curve. B, Sensitivity (true positive/patients with poorly controlled asthma, defined as ACQ-5 ≥1.5), specificity (true negative/patients who do not have poorly controlled asthma, defined as ACQ-5 <1.5), positive predictive value (true positive/test positive), and negative predictive value (true negative/test negative) for the cut points. The Journal of Allergy and Clinical Immunology: In Practice 2013 1, DOI: ( /j.jaip ) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions
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Figure 5 Scatter plot of asthma symptoms as measured by ACQ-5 score versus self-reported reliever use (ACQ Q6). X-axis, ACQ Question 6 asks respondents to rate their average daily reliever use over the preceding 7 days in the following categories: score 0, none; score 1, 1 to 2 albuterol inhalations most days; score 2, 3 to 4 albuterol inhalations most days; score 3, 5 to 8 albuterol inhalations most days; score 4, 9 to 12 albuterol inhalations most days; score 5, 13 to 16 albuterol inhalations most days; score 6, >16 albuterol inhalations most days. Y-axis, ACQ-5 score (range, 0-6), where a score of ≤0.75 represents well-controlled asthma and a score of ≥1.5 represents not well-controlled asthma. Reference lines are shown at these thresholds. The Journal of Allergy and Clinical Immunology: In Practice 2013 1, DOI: ( /j.jaip ) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions
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