Article validation of an index for functionally important respiratory symptoms among adults in the nationally representative population assessment of tobacco and health study, 2014–2016

Michael J. Halenar, James D. Sargent, Kathryn C. Edwards, Steven Woloshin, Lisa Schwartz, Jennifer Emond, Susanne Tanski, John P. Pierce, Kristie A. Taylor, Kristin Lauten, Maciej L. Goniewicz, Raymond Niaura, Gabriella Anic, Yanling Chen, Priscilla Callahan-Lyon, Lisa D. Gardner, Theresa Thekkudan, Nicolette Borek, Heather L. Kimmel, K. Michael CummingsAndrew Hyland, Mary F. Brunette

Research output: Contribution to journalArticlepeer-review

Abstract

The purpose of this study is to validate the seven-item wheezing module from the International Study of Asthma and Allergies in Children (ISAAC) in the nationally representative Population Assessment of Tobacco and Health Study. Adult participants with complete Wave 2–3 data were selected, including those with asthma but excluding those with COPD and other respiratory diseases (n = 16,295). We created a nine-point respiratory symptom index from the ISAAC questions, assessed the reliability of the index, and examined associations with self-reported asthma diagnosis. Threshold values were assessed for association with functional outcomes. The weighted prevalence for one or more respiratory symptom was 18.0% (SE = 0.5) for adults without asthma, 70.1% (SE = 1.3) for those with lifetime asthma, 75.7% (SE = 3.7) for adults with past-year asthma not on medi-cations, and 92.6% (SE = 1.6) for those on medications. Cronbach’s alpha for the respiratory symptom index was 0.86. Index scores of ≥2 or ≥3 yielded functionally important respiratory symptom prevalence of 7–10%, adequate sensitivity and specificity for identifying asthma, and consistent in-dependent associations with all functional outcomes and tobacco use variables. Respiratory symptom index scores of ≥2 or ≥3 are indicative of functionally important respiratory symptoms and could be used to assess the relationship between tobacco use and respiratory health.

Original languageEnglish (US)
Article number9688
JournalInternational journal of environmental research and public health
Volume18
Issue number18
DOIs
StatePublished - Sep 2021

Keywords

  • Functional outcomes
  • PATH Study
  • Patient-reported outcomes
  • Respiratory health
  • Tobacco use
  • Wheeze

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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