Validation of the Asthma Severity Scoring System (ASSESS) in the ALLIANCE Cohort - 05/06/23
Doi : 10.1016/j.jaci.2023.01.027
Ruth Grychtol, MD a, b, ∗, Lennart Riemann, MD a, c, d, ∗, Svenja Gaedcke, MSc b, Bin Liu, MSc b, David DeLuca, PhD b, Reinhold Förster, PhD d, q, Nicole Maison, MD e, f, g, Dominik Thiele, MSc h, i, Nikolas Jakobs, MD i, j, Thomas Bahmer, MD i, k, l, Meike Meyer, MD m, Svenja Foth, MD n, o, Stefanie Weber, MD n, o, Ernst Rietschel, MD m, Klaus F. Rabe, MD i, l, Matthias V. Kopp, MD i, j, p, Erika von Mutius, MD e, f, g, Anna-Maria Dittrich, MD a, b, ‡, Gesine Hansen, MD a, b, c, q, ‡, ⁎ 
and the
and the
ALLIANCE Study Group as part of the German Center for Lung Research (DZL)§
Oliver Fuchs, MD, PhD, Barbara Roesler, MD, Nils Welchering, MD, Naschla Kohistani-Greif, MD, Johanna Kurz, MSc, Katja Landgraf-Rauf, PhD, Kristina Laubhahn, MSc, Nicole Maison, MD, Claudia Liebl, PhD, Bianca Schaub, MD, Markus Ege, MD, Erika von Mutius, MD, MSc, Sabina Illi, Alexander Hose, Esther Zeitlmann, Mira Berbig, Carola Marzi, Christina Schauberger, Ulrich Zissler, PhD, Carsten Schmidt-Weber, PhD, Isabell Ricklefs, MD, Gesa Diekmann, MD, Lena Liboschik, MD, Gesche Voigt, MD, Laila Sultansei, MD, Markus Weckmann, PhD, Matthias V. Kopp, MD, Gyde Nissen, MD, Inke R. König, PhD, Dominik Thiele, MSc, Thomas Bahmer, MD, Anne-Marie Kirsten, MD, Frauke Pedersen, PhD, Henrik Watz, MD, Benjamin Waschki, MD, Klaus F. Rabe, MD, PhD, Christian Herzmann, MD, Mustafa Abdo, MD, Heike Biller, MD, Karoline I. Gaede, PhD, Xenia Bovermann, MD, Alena Steinmetz, MD, Berrit Liselotte Husstedt, MD, Catharina Nitsche, MD, Vera Veith, PhD, Marlen Szewczyk, MSc, Folke Brinkmann, MD, Anna-Maria Dittrich, MD, Christine Happle, MD, Ruth Grychtol, MD, Aydin Malik, MD, Nicolaus Schwerk, MD, Christian Dopfer, MD, Mareike Price, MD, Gesine Hansen, MD, Adan Chari Jirmo, PhD, Anika Habener, Dipl-Biol, David S. DeLuca, PhD, Svenja Gaedcke, MSc, Bin Liu, MSc, Mifflin-Rae Calveron, MSc, Stefanie Weber, MD, Svenja Foth, MD, Chrysanthi Skevaki, MD, Harald Renz, MD, Meike Meyer, MD, Tom Schildberg, MD, Ernst Rietschel, MD, Silke van Koningsbruggen-Rietschel, MD, Miguel Alcazar, MD
a Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
b Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
c Else Kröner-Fresenius Stiftung, Forschungskolleg TITUS, Hannover Medical School, Hannover, Germany
d Institute of Immunology, Hannover Medical School, Hannover, Germany
e Institute for Asthma and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
f Dr von Hauner Children’s Hospital, Ludwig Maximilian University, Munich, Germany
g Comprehensive Pneumology Center-Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
h Institute of Medical Biometry and Statistics, University Medical Center Schleswig-Holstein, Luebeck, Germany
i Airway Research Center North (ARCN), Member of German Center for Lung Research (DZL), Germany
j Section for Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Luebeck, Germany
k Department of Internal Medicine I, Pneumology, University Hospital Schleswig-Holstein, Kiel, Germany
l LungenClinic Grosshansdorf, Grosshansdorf, Germany
m Faculty of Medicine, University Children’s Hospital, University of Cologne, Cologne, Germany
n Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany
o University Children’s Hospital Marburg, University of Marburg, Marburg, Germany
p Department of Pediatric Respiratory Medicine, Inselspital, University Children’s Hospital of Bern, University of Bern, Bern, Switzerland
q Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany's Excellence Strategy—EXC 2155 “RESIST”, Germany
∗Corresponding author: Gesine Hansen, MD, Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.Department of Paediatric PneumologyAllergology and NeonatologyHannover Medical SchoolCarl-Neuberg-Str. 1Hannover30625Germany
Abstract |
Background |
The Asthma Severity Scoring System (ASSESS) quantifies asthma severity in adolescents and adults. Scale performance in children younger than 12 years is unknown.
Objective |
To validate the ASSESS score in the All Age Asthma Cohort and explore its use in children younger than 12 years.
Methods |
Scale properties, responsiveness, and known-group validity were assessed in 247 children (median age, 11 years; interquartile range, 8-13 years) and 206 adults (median age, 52 years; interquartile range, 43-63 years).
Results |
Overall, measures of internal test consistency and test-retest reliability were similar to the original data of the Severe Asthma Research Program. Cronbach α was 0.59 in children aged 12 to 18 years and 0.73 in adults, reflecting the inclusion of multiple and not-always congruent dimensions to the ASSESS score, especially in children. Analysis of known-group validity confirmed the discriminatory power, because the ASSESS score was significantly worse in patients with poor asthma control, exacerbations, and increased salbutamol use. In children aged 6 to 11 years, test-retest reliability was inferior compared with that in adults and adolescents (Cronbach α, 0.27) mostly because of a less lung function impairment in children with asthma of this age group. Known-group validity, however, confirmed good discriminative power regarding severity-associated variables similar to adolescents and adults.
Conclusions |
Test-retest reliability and validity of the ASSESS score was confirmed in the All Age Asthma Cohort. In children aged 6 to 11 years, internal consistency was inferior compared with that in older patients with asthma; however, test validity was good and thus encourages age-spanning usage of the ASSESS score in all patients 6 years or older.
Le texte complet de cet article est disponible en PDF.Key words : ALLIANCE, asthma, asthma control, asthma severity, children, pediatric asthma, adult asthma, validation study
Abbreviations used : ACT, ALLIANCE, AQLQ, ASSESS, CASI, GINA, ICC, IQR, MID
Plan
| The ALLIANCE study is supported by project grants from the German Federal Ministry of Education and Research as part of the German Center for Lung Research funding. Further funding was provided by the Cluster of Excellence RESIST (DFG, German Research Foundation) and the Dörenkamp Foundation. L.R. was supported by the TITUS (The First Thousand Days of Life) Clinician Scientist Program, which is funded by the Else Kröner-Fresenius-Stiftung. |
|
| Disclosure of potential conflict of interest: T. Bahmer reports funding from the Network University Medicine/German Federal Ministry of Education and Research, grants from the German Center for Lung Research, and personal fees from AstraZeneca, GlaxoSmithKline, Novartis, Roche, Chiesi, Boehringer Ingelheim, Merck, and Pfizer, and participates on a data safety monitoring board/advisory board of CoVit-2 (NCT04751604). E. Rietschel reports personal lecture payments for Nutricia Milupa GmbH and Novartis and honoraria for participation in advisory boards for MICE-Mylan, Novartis, and Boehringer Ingelheim. K. F. Rabe reports personal payments or honoraria from AstraZeneca, Boehringer Ingelheim, Chiesi Pharmaceuticals, Novartis, Sanofi Regeneron, GlaxoSmithKline, Berlin Chemie, and Roche; participates on data safety monitoring boards/advisory boards for AstraZeneca and Sanofi Regeneron; and discloses leadership or fiduciary role in the German Center for Lung Research, the German Chest Society, and the American Thoracic Society. M. V. Kopp reports grants and personal fees from Allergopharma GmbH and Vertex GmbH and additional personal fees from Sanofi, Infectopharm GmbH, and Leti GmbH. E. von Mutius reports grants from the German Center for Lung Research, royalties/licenses held by Elsevier GmbH, Georg Thieme Verlag, Springer-Verlag GmbH, Elsevier Ltd, and Springer Nature Group, and consultation fees from the Chinese University of Hong Kong, the European Commission, HiPP GmbH, AstraZeneca, Imperial College London, OM Pharma, and ALK-Abello Arzneimittel GmbH; discloses payments and/or support for meetings/travel from the Massachusetts Medical Society, Springer-Verlag GmbH, Elsevier Ltd, Boehringer Ingelheim, European Respiratory Society, Universiteit Utrecht, Universität Salzburg, Springer-Verlag GmbH, Japanese Society of Pediatric Allergy and Clinical Immunology, Klinikum rechts der Isar, University of Colorado, Paul-Martini Stiftung, AstraZeneca, Imperial College London, Children’s Hospital Research Institute of Manitoba, Kompetenzzentrum für Ernährung (Kern), OM Pharma, Swedish Pediatric Society for Allergy and Lung Medicine, Chinese College of Allergy and Asthma, ALK-Abello Arzneimittel GmbH, Abbott Laboratories, Deutscher Apotheker Verlag GmbH & Co. KG, Verein zur Förderung der Pneumologie am Krankenhaus Großhaderndorf e.V., Pneumologie Development, Mondial Congress & Events GmbH & Co. KG, American Academy of Allergy, Asthma & Clinical Immunology, Imperial College London, Margaux Orange, Volkswagen Stiftung, Österreichische Gesellschaft für Allergologie und Immunologie, Hanson Wade Ltd, iKOMM GmbH, Fabio Luigi Massimo Ricciardolo/Conttato S.r.l., Fraunhofer ITEM Hannover, MCCA Institut für Immunologie Uni Wien, Swiss Institute of Allergy and Asthma Research Davos (associated institute of the University of Zurich), Medical School Hannover, and Natastha Allergy Research Foundation; has patent number PCT/EP2019/085016 pending, EP2361632, EP1411977, EP1637147, EP1964570, EP21189353.2, and PCT/US2021/016918; and is a member of the following data monitoring/advisory boards: EXPANSE, BEAMS External Scientific Advisory Board, Journal of Allergy and Clinical Immunology: In Practice, Children’s Respiratory and Environmental Workgroup, International Scientific & Societal Advisory Board of Utrecht Life Sciences, External Review Panel of the Faculty of Veterinary Science (University of Utrecht), Gottfried Wilhelm Leibniz Programme, Asthma UK for Applied Research, Advisory Board of The Lancet Respiratory Medicine, Canadian Healthy Infant Longitudinal Development Study, Pediatric Scientific Advisory Board Iceland, and Abbott Allergy Risk Reduction Advisory Board. G. Hansen reports grants from the German Federal Ministry of Education and Research, German Center for Lung Research, and German Research Foundation as well as personal fees from Sanofi GmbH, MedUpdate, and Abbvie. The rest of the authors declare that they have no relevant conflicts of interest. |
© 2023
The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 151 - N° 6
P. 1525 - juin 2023 Retour au numéro
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