Validation of an Index for Functionally Important Respiratory Symptoms among Adults in the Nationally Representative Population Assessment of Tobacco and Health Study, 2014–2016

Michael J. Halenar, James D. Sargent, Kathryn C. Edwards, Steven Woloshin, Lisa Schwartz, Jennifer Emond, Susanne Tanski, John P. Pierce, Kristie A. Taylor, Kristin Lauten, Maciej L. Goniewicz, Raymond Niaura, Gabriella Anic, Yanling Chen, Priscilla Callahan-Lyon, Lisa D. Gardner, Theresa Thekkudan, Nicolette Borek, Heather L. Kimmel, K. Michael Cummings, Andrew Hyland and Mary F. Brunette
Additional contact information
Michael J. Halenar: Westat, Rockville, MD 20850, USA
James D. Sargent: Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA
Kathryn C. Edwards: Westat, Rockville, MD 20850, USA
Steven Woloshin: Dartmouth Institute for Health Policy and Clinical Practice, The C. Everett Koop Institute at Dartmouth, The Lisa Schwartz Foundation, Lebanon, NH 03766, USA
Lisa Schwartz: Dartmouth Institute for Health Policy and Clinical Practice, The C. Everett Koop Institute at Dartmouth, The Lisa Schwartz Foundation, Lebanon, NH 03766, USA
Jennifer Emond: Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA
Susanne Tanski: Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA
John P. Pierce: Moores Cancer Center, University of California at San Diego, La Jolla, CA 92037, USA
Kristie A. Taylor: Westat, Rockville, MD 20850, USA
Kristin Lauten: Westat, Rockville, MD 20850, USA
Maciej L. Goniewicz: Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
Raymond Niaura: School of Global Public Health, New York University, New York, NY 10012, USA
Gabriella Anic: Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA
Yanling Chen: Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA
Priscilla Callahan-Lyon: Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA
Lisa D. Gardner: Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA
Theresa Thekkudan: Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA
Nicolette Borek: Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA
Heather L. Kimmel: National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20852, USA
K. Michael Cummings: Department of Psychiatry & Behavioral Science, Medical University of South Carolina, Mt. Pleasant, SC 29464, USA
Andrew Hyland: Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
Mary F. Brunette: Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA

IJERPH, 2021, vol. 18, issue 18, 1-13

Abstract: The purpose of this study is to validate the seven-item wheezing module from the International Study of Asthma and Allergies in Children (ISAAC) in the nationally representative Population Assessment of Tobacco and Health Study. Adult participants with complete Wave 2–3 data were selected, including those with asthma but excluding those with COPD and other respiratory diseases ( n = 16,295). We created a nine-point respiratory symptom index from the ISAAC questions, assessed the reliability of the index, and examined associations with self-reported asthma diagnosis. Threshold values were assessed for association with functional outcomes. The weighted prevalence for one or more respiratory symptom was 18.0% (SE = 0.5) for adults without asthma, 70.1% (SE = 1.3) for those with lifetime asthma, 75.7% (SE = 3.7) for adults with past-year asthma not on medications, and 92.6% (SE = 1.6) for those on medications. Cronbach’s alpha for the respiratory symptom index was 0.86. Index scores of ?2 or ?3 yielded functionally important respiratory symptom prevalence of 7–10%, adequate sensitivity and specificity for identifying asthma, and consistent independent associations with all functional outcomes and tobacco use variables. Respiratory symptom index scores of ?2 or ?3 are indicative of functionally important respiratory symptoms and could be used to assess the relationship between tobacco use and respiratory health.

Keywords: tobacco use; respiratory health; wheeze; functional outcomes; patient-reported outcomes; PATH Study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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