Asthma Impairment and Risk Questionnaire Appropriate to Identify Asthma Control

The Asthma Impairment and Risk Questionnaire (AIRQ) was deemed to represent a measure to identify asthma control status in adults and adolescents that had been validated in a rigorous fashion, according to study results published in the Journal of Allergy and Clinical Immunology: In Practice.

The AIRQ was developed by 190 US scientific experts and primary and specialty care clinicians, based on asthma control and asthma diagnosis literature, management guidelines, and current asthma control questionnaires. A modified Delphi process established 10 equally weighted yes/no impairment and risk questions related to asthma control that were included in the final AIRQ.

In this study, a total of 442 patients (mean age, 44 years) with asthma were followed in specialty practices and completed 15 yes/no impairment and risk questions. Based on the Asthma Control Test (ACT) score and prior-year exacerbations, patients were classified as having well-controlled (47.1%), not well-controlled (25.4%), or very poorly controlled (27.5%) asthma. Logistic regression was used to identify questions in the initial questionnaire with the greatest predictive ability to distinguish patients with various degrees of asthma, and to identify cut-off points for each of the 3 severity classifications.

The final 10-item AIRQ included 6 of the original 10 yes/no questions on impairment and risk and 4 additional questions, all of which fulfilled item selection criteria. This model yielded a receiver operating characteristic (ROC) curve of 0.94 for the identification of well-controlled vs not well-controlled/very poorly controlled asthma, corresponding to the ACT plus prior-year exacerbations standard. In addition, the final 10-item AIRQ model yielded an ROC curve of 0.93 for the identification of well-controlled /not well-controlled vs very poorly controlled asthma. Well-controlled, not well-controlled, and very poorly controlled asthma were best represented by model cut-off points of 0 to 1, 2 to 4, and 5 to 10, respectively.

“Use of AIRQ in clinical practice could serve to heighten awareness of the need for clinical interventions among all health care providers, accelerate identification of patients in primary care who might benefit from specialty referral and reveal to specialists those patients within their practices with unrecognized morbidity,” the study authors noted.

Disclosure: This clinical trial was supported by AstraZeneca. Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Murphy KR, Chipps B, Beuther DA, et al; on behalf of the US PRECISION Advisory Board. Development of the Asthma Impairment and Risk Questionnaire (AIRQ): a composite control measure. J Allergy Clin Immunol Pract. 2020;8(7):2263-2274.