Preliminary development of a questionnaire to measure the extra-pulmonary symptoms of severe asthma

Felice G de; Michael E. Hyland; Joseph W. Lanario; Yuri Antonacci; Rupert C. Jones; Matthew Masoli

doi:10.1186/s12890-021-01730-0

Preliminary development of a questionnaire to measure the extra-pulmonary symptoms of severe asthma

Felice G de, Michael E. Hyland^*, Joseph W. Lanario, Yuri Antonacci, Rupert C. Jones, Matthew Masoli

^*Corresponding author for this work

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Abstract

Abstract Background Research into the effects of asthma treatments on the extra-pulmonary symptoms of severe asthma is limited by the absence of a suitable questionnaire. The aim was to create a questionnaire suitable for intervention studies by selecting symptoms that are statistically associated with asthma pathology and therefore may improve when pathology is reduced. Methods Patients attending a specialist asthma clinic completed the 65-item General Symptom Questionnaire (GSQ-65), a questionnaire validated for assessing symptoms of people with multiple medically unexplained symptoms. Lung function (FEV1%) and cumulative oral corticosteroids (OCS) calculated from maintenance dose plus exacerbations were obtained from clinic records. Pathology was represented by the two components of a principal component analysis (PCA) of FEV1% and OCS. LASSO regression was used to select symptoms that had high coefficients with these two principal components and occurred frequently in severe asthma. Results 100 patients provided data. PCA revealed two components, one where FEV1% and OCS were inversely related and another where they were directly related. LASSO regression revealed 39 symptoms with non-zero coefficients on one or more of the two principal components from which 16 symptoms were selected for the GSQ-A on the basis of magnitude of coefficient and frequency. Asthma symptoms measured by asthma control questionnaires were excluded. The GSQ-A correlated 0.33 and − 0.34 (p = 0.001) with the two principal components. Conclusion The GSQ-A assesses the frequency of 16 heterogenous non-respiratory symptoms that are associated with asthma severity using the statistical combination of FEV1% and OCS.

Original language	English
Number of pages	0
Journal	BMC Pulmonary Medicine
Volume	21
Issue number	1
Early online date	14 Nov 2021
DOIs	https://doi.org/10.1186/s12890-021-01730-0
Publication status	Published - Dec 2021

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title = "Preliminary development of a questionnaire to measure the extra-pulmonary symptoms of severe asthma",

abstract = "Abstract Background Research into the effects of asthma treatments on the extra-pulmonary symptoms of severe asthma is limited by the absence of a suitable questionnaire. The aim was to create a questionnaire suitable for intervention studies by selecting symptoms that are statistically associated with asthma pathology and therefore may improve when pathology is reduced. Methods Patients attending a specialist asthma clinic completed the 65-item General Symptom Questionnaire (GSQ-65), a questionnaire validated for assessing symptoms of people with multiple medically unexplained symptoms. Lung function (FEV1%) and cumulative oral corticosteroids (OCS) calculated from maintenance dose plus exacerbations were obtained from clinic records. Pathology was represented by the two components of a principal component analysis (PCA) of FEV1% and OCS. LASSO regression was used to select symptoms that had high coefficients with these two principal components and occurred frequently in severe asthma. Results 100 patients provided data. PCA revealed two components, one where FEV1% and OCS were inversely related and another where they were directly related. LASSO regression revealed 39 symptoms with non-zero coefficients on one or more of the two principal components from which 16 symptoms were selected for the GSQ-A on the basis of magnitude of coefficient and frequency. Asthma symptoms measured by asthma control questionnaires were excluded. The GSQ-A correlated 0.33 and − 0.34 (p = 0.001) with the two principal components. Conclusion The GSQ-A assesses the frequency of 16 heterogenous non-respiratory symptoms that are associated with asthma severity using the statistical combination of FEV1% and OCS. ",

author = "de, {Felice G} and Hyland, {Michael E.} and Lanario, {Joseph W.} and Yuri Antonacci and Jones, {Rupert C.} and Matthew Masoli",

year = "2021",

month = dec,

doi = "10.1186/s12890-021-01730-0",

language = "English",

volume = "21",

journal = "BMC Pulmonary Medicine",

issn = "1471-2466",

publisher = "BioMed Central Ltd.",

number = "1",

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T1 - Preliminary development of a questionnaire to measure the extra-pulmonary symptoms of severe asthma

AU - de, Felice G

AU - Hyland, Michael E.

AU - Lanario, Joseph W.

AU - Antonacci, Yuri

AU - Jones, Rupert C.

AU - Masoli, Matthew

PY - 2021/12

Y1 - 2021/12

N2 - Abstract Background Research into the effects of asthma treatments on the extra-pulmonary symptoms of severe asthma is limited by the absence of a suitable questionnaire. The aim was to create a questionnaire suitable for intervention studies by selecting symptoms that are statistically associated with asthma pathology and therefore may improve when pathology is reduced. Methods Patients attending a specialist asthma clinic completed the 65-item General Symptom Questionnaire (GSQ-65), a questionnaire validated for assessing symptoms of people with multiple medically unexplained symptoms. Lung function (FEV1%) and cumulative oral corticosteroids (OCS) calculated from maintenance dose plus exacerbations were obtained from clinic records. Pathology was represented by the two components of a principal component analysis (PCA) of FEV1% and OCS. LASSO regression was used to select symptoms that had high coefficients with these two principal components and occurred frequently in severe asthma. Results 100 patients provided data. PCA revealed two components, one where FEV1% and OCS were inversely related and another where they were directly related. LASSO regression revealed 39 symptoms with non-zero coefficients on one or more of the two principal components from which 16 symptoms were selected for the GSQ-A on the basis of magnitude of coefficient and frequency. Asthma symptoms measured by asthma control questionnaires were excluded. The GSQ-A correlated 0.33 and − 0.34 (p = 0.001) with the two principal components. Conclusion The GSQ-A assesses the frequency of 16 heterogenous non-respiratory symptoms that are associated with asthma severity using the statistical combination of FEV1% and OCS.

AB - Abstract Background Research into the effects of asthma treatments on the extra-pulmonary symptoms of severe asthma is limited by the absence of a suitable questionnaire. The aim was to create a questionnaire suitable for intervention studies by selecting symptoms that are statistically associated with asthma pathology and therefore may improve when pathology is reduced. Methods Patients attending a specialist asthma clinic completed the 65-item General Symptom Questionnaire (GSQ-65), a questionnaire validated for assessing symptoms of people with multiple medically unexplained symptoms. Lung function (FEV1%) and cumulative oral corticosteroids (OCS) calculated from maintenance dose plus exacerbations were obtained from clinic records. Pathology was represented by the two components of a principal component analysis (PCA) of FEV1% and OCS. LASSO regression was used to select symptoms that had high coefficients with these two principal components and occurred frequently in severe asthma. Results 100 patients provided data. PCA revealed two components, one where FEV1% and OCS were inversely related and another where they were directly related. LASSO regression revealed 39 symptoms with non-zero coefficients on one or more of the two principal components from which 16 symptoms were selected for the GSQ-A on the basis of magnitude of coefficient and frequency. Asthma symptoms measured by asthma control questionnaires were excluded. The GSQ-A correlated 0.33 and − 0.34 (p = 0.001) with the two principal components. Conclusion The GSQ-A assesses the frequency of 16 heterogenous non-respiratory symptoms that are associated with asthma severity using the statistical combination of FEV1% and OCS.

U2 - 10.1186/s12890-021-01730-0

DO - 10.1186/s12890-021-01730-0

M3 - Article

SN - 1471-2466

VL - 21

JO - BMC Pulmonary Medicine

JF - BMC Pulmonary Medicine

IS - 1

ER -

Preliminary development of a questionnaire to measure the extra-pulmonary symptoms of severe asthma

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