The Severe Asthma Global Evaluation (SAGE) has demonstrated validity in systematically detecting difficult asthma, according to a report recently published in the Journal of Allergy and Clinical Immunology: In Practice.
The SAGE electronic platform includes a questionnaire battery for patients to complete prior to a visit with clinicians, modules on asthma and comorbidities, a clinical summary page, a panel discussion record, a nurse educator section, and an automatically generated report containing all relevant data. There are 282 input fields for clinicians, although consultations generally require 169 completed fields. SAGE includes 34 autocalculations and 20 tools for support on decisions. All 95 essential parameters of the International Severe Asthma Registry are included, and the 2 platforms are compatible.
SAGE’s comorbidity module was compared with the referring specialist’s comorbidity diagnosis, and it demonstrated the ability to significantly increase detection of comorbidities. A cross-sectional analysis of the protocol’s initial 90 patients was performed to validate SAGE’s auditing of clinical activity. SAGE has also demonstrated utility for research through regression analysis. Significantly improved control of asthma symptoms was demonstrated in the first 65 patients with difficult asthma using SAGE, with improved Asthma Control Test scores (from 14±5 to 16±6; P <.001) and fewer exacerbations (from 2 to 0; P <.001). The structured panel discussion element has demonstrated results in altering management of 18% of patients at the study’s institution.
Limitations to this study include difficulties completing questionnaires in participants who were cognitively impaired, illiterate, non-English speaking, and did not have internet access.
The researchers concluded that “[s]ystematic assessment of difficult asthma improves detection of comorbidities and improves severe asthma outcomes. We have described and validated SAGE, an electronic platform that supports such systematic evaluation, and outlined clinical and research benefits that can accrue from its use. SAGE is now available for free download and its use should enhance the clinical management of patients with difficult and severe asthma.”
Disclosures: Several authors report financial associations with pharmaceutical companies. For a full list of author disclosures, see the reference.
Denton E, Hore-Lacy F, Radhakrishna N, et al. Severe Asthma Global Evaluation (SAGE): an electronic platform for severe asthma [published online April 4, 2019]. J Allergy Clin Immunol Pract. doi:10.1016/j.jaip.2019.02.042