Actual over best function as an outcome measure in asthma
| Autor: | C K Connolly, A.A. Gatnash, S.M. Alcock, Robin J Prescott |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Treatment outcome Peak Expiratory Flow Rate Sex Factors Sex factors Forced Expiratory Volume medicine Humans Patient compliance Lung Asthma Protocol (science) business.industry Outcome measures Function (mathematics) Middle Aged medicine.disease Respiratory Function Tests Treatment Outcome Physical therapy Patient Compliance Female business |
| Zdroj: | Respiratory Medicine. 88:453-459 |
| ISSN: | 0954-6111 |
| DOI: | 10.1016/s0954-6111(05)80049-6 |
| Popis: | Several guidelines for the management of asthma suggest that actual/best function is a useful outcome measure. This implies accurate assessment of best function, and a standard for the proportion of best function to be achieved. Seventeen clinics observed their practice simultaneously during four periods in 1990. The aims of the study included testing a protocol for the assessment of best function, and validating actual/best function as an outcome measure. The proposed target for actual/best function to indicate satisfactory control was 80%. The protocol for assessment of best function required formal trial of steroids if best function was70% predicted; with regular recording of peak expiratory flow (PEF) if80% predicted. PEF was recorded in 515 and FEV1 in 680 of 767 subjects, following the usual clinic practice. If the protocol for best function was not satisfied, mean actual/best function was no higher than if it was, except when best PEF was70% predicted. This suggests the need for a PEF chart in these latter patients. Best function was greater in females than males, but actual/best function was almost identical. Whilst best function declined with increasing intensity of treatment, actual/best function was almost independent of regimen step, particularly in the centre which most closely adhered to the protocol. These results confirm that actual/best function is a valid outcome measure. Mean actual/best was80% except for FEV1 in two centres. It is suggested that the target in chronic management of asthma is raised from 80 to 85% of best, when actual/best PEF is used as a spot check in patients believed to be on optimal therapy. |
| Databáze: | OpenAIRE |
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