Comparison of an expert system with other clinical scores for the evaluation of severity of asthma

Gautier, V.; Redier, H.; Pujol, Jean-Louis; Bousquet, Jean; Proudhon, H.; Michel, C; Daurès, Jean‐Pierre; Michel, François; Godard, P.

doi:10.1183/09031936.96.09010058

Cited by 29 publications

(13 citation statements)

References 28 publications

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“…The aim was not to propose new scores, as this would probably result in conflicting classifications as shown in previous studies [18] and the authors had no criteria with which to choose the best score. The relevance of the guidelines to reality were also not assessed, as this has been carried out in other studies [19].…”

Section: Discussionmentioning

confidence: 99%

Using Global Initiative for Asthma guidelines to assess asthma severity in populations

Liard¹,

Leynaert²,

Zureik³

et al. 2000

Eur Respir J

103

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The classification of asthmatics into severity categories is a crucial issue for assessing the asthma burden within a community, in which a proportion of patients is currently treated. There is no epidemiological method currently available.The Global Initiative for Asthma (GINA) was used to classify 4,362 patients aged 16±45 yrs (49% males, 42% taking inhaled corticosteroids), enrolled by 545 chest specialists in France with short standardized questionnaires including forced expiratory volume in one second (FEV1) measurements. Two independent GINA classifications were combined, one based only on symptoms and FEV1, and the other based only on current medication, to construct a final "symptom-FEV1 medication" classification.Almost 40% of the patients classed as step 1, 30% of those classed as step 2 and 13% of those classed as step 3 in the initial symptom-FEV1-classification, were allocated to categories of higher severity in the final classification. The approach was validated by showing that the proportions of: 1) patients considered by the physicians as having severe or moderately severe asthma; 2) patients with a history of hospital admission for asthma; and 3) patients with a history of emergency department visits for asthma, increased with severity steps in the final classification, for each step of the two initial independent classifications.The treatment manage plan in the Global Initiative for Asthma was not developed for assessing severity of asthma but rather to describe the recommended therapy for asthma with different severity. This is the first attempt to assess the severity of asthma in a large population of asthmatics mostly taking treatment, based on the Global Initiative for Asthma guidelines. The authors propose this simple and pragmatic procedure for a potential classification which should be put to the test in other studies. Eur Respir J 2000; 16: 615±620.

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Section: Discussionmentioning

confidence: 99%

Using Global Initiative for Asthma guidelines to assess asthma severity in populations

Liard¹,

Leynaert²,

Zureik³

et al. 2000

Eur Respir J

103

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“…Results of Peak Expiratory Flow (PEF) during 2 weeks and frequency of Severe Exacerbation (FSE) leading to hospitalization have been recognized as power tools for determining asthma instability [7,8,11,[13][14][15][16]29]. A patient with even one time of asthma exacerbation during a year has Fig.…”

Section: Module Of Asthma Instabilitymentioning

confidence: 99%

“…Variables of Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), and FEV1/ FVC are considered as indicators of spirometry test for measuring of airflow obstruction [7,8,11,[13][14][15][16]31]. Results of these tests may deal with some uncertainties [16,[24][25][26][27][28]36] that have negative effects on accurate assessment of degree of bronchial obstruction and as a result assessment of asthma severity level.…”

Section: B Module Of Bronchial Obstructions (Bo)mentioning

confidence: 99%

“…Knowledge-base of this fuzzy system is composed based on knowledge extracted from a wide range of guidelines covering 10 scores. These scores include Aas score [10], Hargreave Score [11], Disease severity score [12], Artificial intelligence score [7], Gina score (2006) [13], Gina score (2007) [8], Gina score (2008) [19], Canadian Asthma Consensus Report Score (CACRS) [14], Prediction of Control State of Asthma Score (PCSAS) [15], and Expert Panel Report 2 Score (EPRS) [16]. Asthma severity is a continuum process Fig.…”

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confidence: 99%

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Fuzzy Rule-Based Expert System for Assessment Severity of Asthma

et al. 2010

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Prescription medicine for asthma at primary stages is based on asthma severity level. Despite major progress in discovering various variables affecting asthma severity levels, disregarding some of these variables by physicians, variables' inherent uncertainty, and assigning patients to limited categories of decision making are the major causes of underestimating asthma severity, and as a result low quality of life in asthmatic patients. In this paper, we provide a solution of intelligence fuzzy system for this problem. Inputs of this system are organized in five modules of respiratory symptoms, bronchial obstruction, asthma instability, quality of life, and asthma severity. Output of this system is degree of asthma severity in score (0-10). Evaluating performance of this system by 28 asthmatic patients reinforces that the system's results not only correspond with evaluations of physicians, but represent the slight differences of asthmatic patients placed in specific category introduced by guidelines.

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“…The GINA guidelines 1 classify the disease as intermittent and persistent with severe, moderate, and mild degrees of the persistent disease. There are now a number of scores available to define the severity of asthma [3][4][5] based on a combination of symptoms, measurements of airway function, and need for medication.…”

mentioning

confidence: 99%