Allergy Asthma Immunol Res.  2017 Jan;9(1):43-51. 10.4168/aair.2017.9.1.43.

Development and Validation of an Attitudinal-Profiling Tool for Patients With Asthma

Affiliations
  • 1Section of Pulmonary Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines. asdavidwang1@up.edu.ph
  • 2Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
  • 3Observational & Pragmatic Research Institute Pte Ltd, Singapore.
  • 4College of Medicine, Seoul National University, Seoul, Korea.
  • 5Department of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China.
  • 6Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
  • 7Medical Affairs Department, Mundipharma Pte Ltd, Singapore.
  • 8Research Partnership Pte Ltd, Singapore.

Abstract

PURPOSE
To develop a profiling tool which accurately assigns a patient to the appropriate attitudinal cluster for the management of asthma.
METHODS
Attitudinal data from an online survey of 2,467 patients with asthma from 8 Asian countries/region, aged 18-50 years, having had ≥2 prescriptions in the previous 2 years and access to social media was used in a discriminant function analysis to identify a minimal set of questions for the Profiling Tool. A split-sample procedure based on 100 sets of randomly selected estimation and validation sub-samples from the original sample was used to cross-validate the Tool and assess the robustness of its predictive accuracy.
RESULTS
Our Profiling Tool contained 10 attitudinal questions for the patient and 1 GINA-based level of asthma control question for the physician. It achieved a predictive accuracy of 76.2%. The estimation and validation sub-sample accuracies of 76.7% and 75.3%, respectively, were consistent with the tool's predictive accuracy at 95% confidence level; and their 1.4 percentage-points difference set upper-bound estimate for the degree of over-fitting.
CONCLUSIONS
The Profiling Tool is highly predictive (>75%) of the attitudinal clusters that best describe patients with asthma in the Asian population. By identifying the attitudinal profile of the patient, the physician can make the appropriate asthma management decisions in practice. The challenge is to integrate its use into the consultation workflow and apply to areas where Internet resources are not available or patients who are not comfortable with the use of such technology.

Keyword

Asthma; discriminant analysis; disease management; Asia

MeSH Terms

Asia
Asian Continental Ancestry Group
Asthma*
Discriminant Analysis
Disease Management
Humans
Internet
Prescriptions
Social Media

Figure

  • Fig. 1 Patient attitudinal clusters.

  • Fig. 2 REALISE Asia patient survey flowchart.

  • Fig. 3 Demographic, socio-economic, and disease profiles by country.

  • Fig. 4 Attitudinal cluster profile by country.

  • Fig. 5 Predictive accuracy rates corresponding to the number of predictor variables for iHARP variable combinations.

  • Fig. 6 Ranked accuracy rates of estimation and validation sub-samples.

  • Fig. 7 Scatter plot of accuracy rates of validation sub-samples to estimation sub-samples.


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