assessing asthma control in uk primary care use of routinely collected prospective observational consultation data to determine appropriateness of a variety of control assessment models评估哮喘控制在英国初级保健使用定期收集前瞻性观察性咨询数据来确定恰当的各种控制评估模型.pdfVIP

Hoskins et al. BMC Family Practice 2011, 12:105 /1471-2296/12/105 RESEARCH ARTICLE Open Access Assessing Asthma control in UK primary care: Use of routinely collected prospective observational consultation data to determine appropriateness of a variety of control assessment models 1* 2 3 4 1 Gaylor Hoskins , Brian Williams , Cathy Jackson , Paul D Norman and Peter T Donnan Abstract Background: Assessing asthma control using standardised questionnaires is recommended as good clinical practice but there is little evidence validating their use within primary care. There is however, strong empirical evidence to indicate that age, weight, gender, smoking, symptom pattern, medication use, health service resource use, geographical location, deprivation, and organisational issues, are factors strongly associated with asthma control. A good control measure is therefore one whose variation is most explained by these factors. Method: Eight binary (Yes = poor control, No = good control) models of asthma control were constructed from a large UK primary care dataset: the Royal College of Physicians 3-Questions (RCP-3Qs); the Jones Morbidity Index; three composite measures; three single component models. Accounting for practice clustering of patients, we investigated the effects of each model for assessing control. The binary models were assessed for goodness-of-fit statistics using Pseudo R-squared and Akaikes Information Criteria (AIC), and for performance using Area Under the Receiver Operator Characteristic (AUROC). In addition, an expanded RCP-3Q control scale (0-9) was derived and assessed with linear modelling. The analysis identified which model was best explained by the independent variables and thus could