Identification of adults with symptoms suggestive of obstructive airways disease: Validation of a postal respiratory questionnaire

Abstract

Background: Two simples scoring systems for a self-completed postal respiratory questionnaire were developed to identify adults who may have obstructive airways disease. The objective of this study was to validate these scoring systems.

Smoking, respiratory symptoms and likely asthma in young people: evidence from postal questionnaire surveys in the Wythenshawe Community Asthma Project (WYCAP)

“…Likely asthma was defined as the presence of four positive responses from six key questions in the respiratory questionnaire: wheeze, woken by cough, woken by chest tightness, woken by shortness of breath (all in the previous year), a history of hay fever/eczema and family history of asthma. This simple scoring system was developed and validated for WYCAP and was found useful in identifying subjects with likely obstructive airways disease [ 23 ]. It did not differentiate asthma and COPD, but in the present study, all subjects were aged less than 45 years and so the diagnosis of established COPD was unlikely.…”

Health related quality of life in individuals with asthma related symptoms

“…Validation testing found the reporting of four or more symptoms/risk factors gave a positive predictive value of 0.75 for meriting a trial of obstructive airways disease medication. 10 The six key questions were as follows:…”

Development of a questionnaire weighted scoring system to target diagnostic examinations for asthma in adults: a modelling study

“…In a condition such as asthma there is inherent uncertainty in the diagnosis, and even detailed clinical review information inevitably produces disagreement between experts as to the diagnostic category for some of the reviewed individuals. Other studies have produced questionnaire models for predicting high risk asthmatics [4,9,10,19] and these studies have either used a single expert or resolved the problem of disagreement between experts using methods such as 'majority verdict' or designated diagnostic rules. However, where more than one expert is involved, even permitting the experts to discuss problem cases did not always result in complete agreement [4].…”

“…Conventional targeting approaches which separate individuals into 'positive' and 'negative' categories have failed to reduce the number of potential examinations to a manageable level. For example, in the Wythenshawe Community Asthma Project (WYCAP) [8-10], respondents who had four or more 'yes' answers to six key questions on a postal respiratory questionnaire were deemed possible asthmatics in need of clinical assessment. However, this method identified approximately 350 individuals for examination per practice.…”