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. 2020 Jul-Aug;8(7):2263-2274.e5.
doi: 10.1016/j.jaip.2020.02.042. Epub 2020 May 6.

Development of the Asthma Impairment and Risk Questionnaire (AIRQ): A Composite Control Measure

Kevin R Murphy  1 , Bradley Chipps  2 , David A Beuther  3 , Robert A Wise  4 , William McCann  5 , Ileen Gilbert  6 , James M Eudicone  6 , Hitesh N Gandhi  6 , Gale Harding  7 , Karin S Coyne  7 , Robert S Zeiger  8 ; US PRECISION Advisory Board
Collaborators, Affiliations

Development of the Asthma Impairment and Risk Questionnaire (AIRQ): A Composite Control Measure

Kevin R Murphy et al. J Allergy Clin Immunol Pract. 2020 Jul-Aug.

Erratum in

  • Correction.
    [No authors listed] [No authors listed] J Allergy Clin Immunol Pract. 2021 Jan;9(1):603. doi: 10.1016/j.jaip.2020.10.038. J Allergy Clin Immunol Pract. 2021. PMID: 33429716 No abstract available.

Abstract

Background: Asthma exacerbation risk increases with worsening asthma control. Prevailing numerical control tools evaluate only current symptom impairment despite the importance of also assessing risk based on exacerbation history. An easy-to-use questionnaire addressing impairment and risk domains of control is needed.

Objective: To validate a composite asthma control tool that includes impairment and risk assessments (Asthma Impairment and Risk Questionnaire [AIRQ]).

Methods: Four-hundred forty-two patients aged ≥12 years with physician-diagnosed asthma who were followed in specialty practices completed 15 impairment and risk questions with dichotomized yes/no responses. Patients spanned all Global Initiative for Asthma severities and were classified as well-controlled, not well-controlled, or very poorly controlled according to a standard of Asthma Control Test (ACT) score plus prior-year exacerbations. Logistic regression analyses identified questions with the greatest predictive validity to discriminate among patients and determine cut points for these 3 classifications.

Results: The final AIRQ comprises 10 equally weighted yes/no impairment and risk questions. The final 10-item models yielded receiver operating characteristic curves of 0.94 to identify well-controlled versus not well-/very poorly controlled and 0.93 to identify well-/not well-controlled versus very poorly controlled asthma, as reflected by the ACT plus prior-year exacerbations standard. Cut points of 0-1, 2-4, and 5-10 best represented well-, not well-, and very poorly controlled asthma.

Conclusions: AIRQ is a rigorously validated composite measure designed to identify adults and adolescents with varying degrees of asthma control. Ongoing investigations will determine test-retest reliability, responsiveness to change, and predictive ability for future exacerbations.

Keywords: Asthma; Control; Exacerbation; Impairment; Instrument; Risk; Uncontrolled; Validation.

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