@article{e93f946fc88747388f87e67530be1882,
title = "Development of the Asthma Impairment and Risk Questionnaire (AIRQ): A Composite Control Measure",
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",
author = "{US PRECISION Advisory Board} and Murphy, {Kevin R.} and Bradley Chipps and Beuther, {David A.} and Wise, {Robert A.} and William McCann and Ileen Gilbert and Eudicone, {James M.} and Gandhi, {Hitesh N.} and Gale Harding and Coyne, {Karin S.} and Zeiger, {Robert S.} and Kobernick, {Aaron K.} and Acklema Mohammad and Cherry, {Adam T.} and Alan Fein and Alan Gaines and {Allison Ramsey}, Ramsey and Michaud, {Amanda L.} and Amy Palmer and Kim, {Andrew S.} and Smith, {Andrew M.} and White, {Andrew A.} and Ricci, {Anthony R.} and Kettelhut, {Brett V.} and Modena, {Brian D.} and Brian Stone and Rolston, {B. Steele} and Schnapf, {Bruce M.} and Bryan Krajicek and Cara Kraft and Carly Hopkins and Natalie, {Chitra R.} and Christine Anderson and Christine Czajkowski and Daisy Arce and Danuel Hamlin and Hill, {David G.} and Mares, {David C.} and David Pham and Liao, {Da Wei} and Deborah Simmons and Johnson, {Derek K.} and Jhaveri, {Devi K.} and Maselli, {Diego J.} and Edward Kerwin and Edward Schuman and Sher, {Ellen R.} and Eugene Bleecker and Ewa Rakowski and {Ida Hsu}, Florence",
note = "Funding Information: This work was supported by AstraZeneca (Wilmington, Del). The Asthma Impairment and Risk Questionnaire (AIRQ) was developed with support from the AstraZeneca PRECISION program. Employees of AstraZeneca (IG, JME, and HNG) satisfied all ICMJE requirements for authorship of this manuscript and were therefore involved in study design; the collection, analysis, and interpretation of data; the writing of the manuscript; and the decision to submit the article for publication. Funding Information: Conflicts of interest: K. R. Murphy has served as a consultant and is a speaker for AstraZeneca, Boehringer Ingelheim, Genentech, Greer, Merck, Mylan, Novartis, Regeneron, Sanofi, Optinose, and Teva. B. Chipps has served as an advisor, consultant, and as a speaker for AstraZeneca, Boehringer Ingelheim, Circassia, Genentech, Novartis, Regeneron, and Sanofi. D. A. Beuther has participated in advisory boards for AstraZeneca and GlaxoSmithKline. R. A. Wise has received consultant fees and honoraria from AstraZeneca, GlaxoSmithKline, Novartis, Boehringer Ingelheim, Contrafect, Pulmonx, Roche, Regeneron, AbbVie, Spiration, Sunovion, Merck, Circassia, Pneuma, Verona, Bonti, Denali, Aradigm, Mylan, Theravance, Propeller Health, Kiniksa, and Syneos. W. McCann has served as a consultant and speaker for AstraZeneca; has served as a speaker for Regeneron; and has served as a consultant for Aimmune. I. Gilbert, J. M. Eudicone, and H. N. Gandhi are employees of AstraZeneca. G. Harding and K. S. Coyne are employees of Evidera, which was contracted by AstraZeneca for study design and to collect and analyze data for this study. R. S. Zeiger has received grants from Aerocrine , Genentech , MedImmune / AstraZeneca , Merck , GlaxoSmithKline , ALK Pharma , Teva , and the National Heart , Lung, and Blood Institute ; and has received consultant fees from AstraZeneca, Genentech/Novartis, GlaxoSmithKline, Merck, Regeneron, and Teva. Funding Information: The authors gratefully acknowledge Joan Reibman, MD, for her integral role in defining the scientific and clinical focus of the AIRQ, in developing and refining the initial content of the questionnaire, and for reviewing the manuscript. We gratefully acknowledge Maureen George, PhD, RN, AE-C, FAAN, for providing essential insight into the patient-centric components of the AIRQ and for reviewing the manuscript. We also thank Ram{\'o}n G. Reyes-Almod{\'o}var, MD, Diplomate, American Board of Family Practice, for contributing to the development of the AIRQ. We thank Mark Kosinski for consultation on the analysis and for providing valuable comments on the manuscript. We thank Katelyn Cutts, MS, and Melissa Ross, PhD, of Evidera, and Sara Lavoie, MPH, formerly of Evidera, for their project management of this study; Jeffrey Li, MD, and Sandra Macker of Evidera, for data management; Ren Yu, MA, of Evidera, for statistical programming; and Jack Ishak, PhD, of Evidera, for statistical consultation. Publication support was provided by Carrie Lancos, ELS, CMPP, of AstraZeneca, and Patricia Johansen, PhD, formerly of AstraZeneca. Medical writing support was provided by Irene Ojini, PhD, CMPP, of MedErgy HealthGroup, which was in accordance with Good Publication Practice (GPP3) guidelines and was funded by AstraZeneca (Wilmington, Del). Publisher Copyright: {\textcopyright} 2020 American Academy of Allergy, Asthma & Immunology",
year = "2020",
month = jul,
day = "1",
doi = "10.1016/j.jaip.2020.02.042",
language = "English (US)",
volume = "8",
pages = "2263--2274.e5",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
issn = "2213-2198",
publisher = "Elsevier",
number = "7",
}