There are no standardized methods for recording ambulatory spirometric data, but basic guidelines for laboratory-based testing can be applied (116). Messages 6 Location Alberta, Canada. Novel interventions specifically targeting bronchial hyperresponsiveness need further exploration (219, 220). Currie GP, Fowler SJ, Lipworth BJ. Lenoir M, Williamson A, Stanford RH, Stempel DA. Subjects should always be asked to complete symptom diaries before measuring PEF, to avoid bias. Importantly, MID for quality of life has often been assessed from the investigator's perspective, but is now primarily anchored to the patient's perspective, on the basis of the idea that that only the patient is in a position to judge whether a difference is important.

The time-scale of changes in PC20 and PD20 in response to ICS therapy varies with the challenge agent. Tsoukias NM, George SC. ATS/ERS Recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Muller KC, Jorres RA, Magnussen H, Holz O. Inspection of routinely collected medical or administrative records (344, 345, 366, 367). For example, exhaled nitric oxide has been used as a “predictor” of loss of asthma control (63–65). In several studies, a poor association has been observed between PEF criteria and clinician prescription of corticosteroids. Telephone consultations and nurse consultations should be reported separately. Bronchodilator responsiveness is only weakly associated with measures of AHR and airway inflammation, but is an independent predictor of response to ICS therapy (156, 175). Bandama excusez moi mais cet individu n’est pas un homme. Ahrens RC, Teresi ME, Han SH, Donnell D, Vanden Burgt JA, Lux CR. Ayi exprime l’étonnement, comme han, ou encore tchié. L’une des. Bacci E, Cianchetti S, Bartoli M, Dente FL, Di Franco A, Vagaggini B, Paggiaro P. Low sputum eosinophils predict the lack of response to beclomethasone in symptomatic asthmatic patients. The Task Force members agreed that the output from the Task Force would be a narrative review, identifying and describing measures that were appropriate to the newly established definitions of asthma control and exacerbations. Agreement between caregiver reported healthcare utilization and administrative data for children with asthma. Although many individual ER attendances for asthma will represent severe asthma exacerbations, as reflected by the need for systemic corticosteroids, some may represent attendances for “sick care.” There is value in recording secondary health care attendances as an overall marker of health care utilization for poor asthma control, particularly when the study focus is at a population or community level. In young infants it can predict the development of asthma later in life (210). Although the majority of patients in primary care demonstrate concordance between symptoms and eosinophilic airway inflammation, significant discordance is seen in patients referred for secondary care (288).

The relationship between health-related quality of life, lung function and daily symptoms in patients with persistent asthma. Threshold values for each of these outcome variables, which are usually derived from goals of treatment in asthma guidelines (8, 9, 238), are mostly arbitrary. Michils and coworkers reported that in patients with mild asthma, a decrease in FeNO of greater than 40% had a positive predictive value for improved ACQ of 83% (324). Roche N, Morel H, Martel P, Godard P. Clinical practice guidelines: medical follow-up of patients with asthma - adults and adolescents. Kharitonov SA, Logan-Sinclair RB, Busset CM, Shinebourne EA. Zhang J, Yu C, Holgate ST, Reiss TF.

Airway obstruction is also characteristically variable in asthma, and clinic lung function, if measured after withholding of study medication, does not represent the patient's usual daily on-treatment state. Do direct and indirect challenges have similar predictive value? This was subsequently confirmed by literature reviews performed by individual Working Groups (described below). For clinical trials, pre-BD FEV1 is defined as FEV1 recorded after withholding of SABA and LABA for a period appropriate for their duration of action (e.g., ≥ 6 h for SABA and ≥ 12 h for LABA).

Patients are usually required to achieve control in each outcome and/or for all the days of the week, for most or all the weeks of the assessment period (52, 227). Emerging work on biomarkers suggests that several measures of airway inflammation should be evaluated in a similar way for inclusion in composite control scores.
The definition of what constitutes an unscheduled or emergency consultation is often not specified in publications, and may range from administrative definitions (e.g., request for an appointment within 24 h) to clinical definitions (e.g., consultation judged as being needed for worsening asthma). Zeiger RS, Dawson C, Weiss S. Relationships between duration of asthma and asthma severity among children in the Childhood Asthma Management Program (CAMP).

Some studies excluded use of systemic corticosteroids for less than 3 days (31, 32).

Tasche MJ, van der Wouden JC, Uijen JH, Ponsioen BP, Bernsen RM, van Suijlekom-Smit LW, de Jongste JC. Optimal asthma control, starting with high doses of inhaled budesonide.
O'Byrne PM, Barnes PJ, Rodriguez-Roisin R, Runnerstrom E, Sandstrom T, Svensson K, Tattersfield A. Cluster analysis has demonstrated that with sputum-guided therapy, the majority of benefit in reducing exacerbations occurs in patients with inflammation-predominant asthma, whereas the majority of benefit in reducing ICS dose is seen in patients with predominant symptoms and little inflammation (288). :-). Measures of health care utilization provide surrogate measures for asthma control, which are particularly useful when direct clinical measures are not available, for example, at a population level. The definition of “exacerbation” has also varied within guidelines and between studies. Pre BD FEV1 is influenced by short-term fluctuations in airflow limitation and therefore can be considered as a measure of asthma control.

Aburuz S, McElnay J, Gamble J, Millership J, Heaney L. Relationship between lung function and asthma symptoms in patients with difficult to control asthma. Définition, traduction, prononciation, anagramme et synonyme sur le dictionnaire libre Wiktionnaire. The obvious advantage of numeric composite measures is that absolute values as well as changes in numeric scores are relatively easy for patients and carers to understand and record. FeNO is a reasonably robust estimate of the presence of eosinophilic airway inflammation across a wide range of patients differing in diagnosis (294). Increased nitric oxide in exhaled air of asthmatic patients. Agbou est une expression qui s’est répandue avec les animateurs d’une émission radio en Côte D’Ivoire. Boulet L-P, Boulet V, Milot J. Further work is needed to clarify whether any objective measures predict need/increase of corticosteroids and whether a more detailed recording (for example mg prednisolone/patient/unit time) enhances understanding or quantification of control. Detailed standardized laboratory operating procedures should be at hand.

The Dutch Chronic Non-specific Lung Disease Study Group. These findings indicate that spirometry provides complementary information that is not provided by other outcome variables (3, 173).


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