Chest
Volume 114, Issue 5, November 1998, Pages 1343-1348
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Clinicai Investigations: Asthma
Questionnaire Items That Predict Asthma and Other Respiratory Conditions in Adults

https://doi.org/10.1378/chest.114.5.1343Get rights and content

The International Union Against Tuberculosis and Lung Disease questionnaire is widely used in epidemiologic studies of adult asthma. We examined whether the symptom questions could be classified into groups that represent different “syndromes,” and whether some qu estions are better for predicting asthma than others. We analyzed questionnaire data from a population sample of 1,527 adults aged 18 to 55 years using factor analyses to classify the 17 respiratory symptom questions into four different groups that we termed asthma, cough, breathlessness, and urgent medical visit. The urgent medical visit was a subset of asthma. These four “syndromes” had good validity when measured against airway responsiveness to histamine, atopy to common allergens, lung function, smoking status, and body mass index. Questions that predicted asthma syndrome were those that asked about wheeze at rest or following exercise, asthma attack, chest tightness, and shortness of breath at rest. Questions about cough identified a different group of subjects who apparently did not have asthma. Questions of breathlessness did not aggregate with “asthma” or with “cough syndrome.” The identification of particular questions that measure different respiratory conditions is important for epidemiologic studies when short questionnaires or more precise definitions are required.

Section snippets

Subjects

The studies were conducted in the two regions of New South Wales in October (spring) of 1991 and 1992 in Lismore and Wagga Wagga. Subjects, who were the parents of a randomly selected sample of schoolchildren aged 8 to 11 years, were asked to complete a questionnaire and to attend a location in the town center for lung function and allergy tests. The methods have been described in detail4 and are briefly summarized below.

Questionnaire

We used a shortened version of the IUATLD questionnaire.9 The 17 questions

Results

The characteristics of the study samples have been described in detail.4 To summarize, 58% of the sample were female, 91% were in the age range 30 to 50 years, 19% were current smokers, 8% had AHR, and 46% were atopic. Table 1 shows the prevalence of positive responses to the 17 questionnaire items.

When the principal component analysis was carried out separately for the two regions, the factor patterns were similar in each and to those given in Table 2 for the combined sample. The only

Discussion

By using factor analysis, we found that 16 questions identified four separate respiratory conditions, that is asthma, cough, breathlessness, and a subset of asthma that experienced UMV. These identified groups had good validity against the other physical characteristics that were measured. In this study, the regrouping of symptom questions was derived from original data and based on the internal relationship of the questions. Questions were compared by their item correlations to their factor.

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