Subtypes of asthma based on asthma control and severity: a latent class analysis
Open accessAbstract
BACKGROUND: Asthma subtyping is a complex new field of study. Usually both etiological and outcome factors of asthma have been used simultaneously for subtyping thus making the interpretation of the results difficult. Identification of subtypes of asthma based on questionnaire data only will be useful for both treatment of asthma and for research. Our objective was to identify asthma subtypes that capture both asthma control and severity based on easily accessible variables. METHODS: We applied latent class analysis for the 1995 adult asthmatics, 692 men and 1303 women, of the Northern Finnish Asthma Study (NoFAS). The classifying variables included use of asthma medication within the last 12 months, St. George's Respiratory Questionnaire score, and asthma-related healthcare use within the last 12 months. Covariates adjusted for included COPD, allergic rhinitis/allergic eczema, BMI, age and sex. All information was based on self-administered questionnaires. RESULTS: We identified four subtypes for women: Controlled, mild asthma (41% of participants); Partly controlled, moderate asthma (24%); Uncontrolled asthma, unknown severity (26%), and Uncontrolled, severe asthma (9%). For men we identified three subtypes: Controlled, mild asthma (31%); Poorly controlled asthma, unknown severity (53%); and Partly controlled, severe asthma (17%). For almost 96% of the subjects this subtyping was accurate. The covariates fitted in the model were based on clinical judgment and were good predictors of class membership. CONCLUSIONS: Our results show that it is possible to form meaningful and accurate asthma subtypes based on questionnaire data, and that separate classification should be applied for men and women.
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Latent class analysis methods are able to identify novel and statistically distinct classes among individuals in a relatively unbiased way, based on measured variables that relate to asthma symptoms and/or biomarkers such as bronchial hyperresponsiveness and atopy.
“Essentially, LCA methods are able to identify novel and statistically distinct classes among individuals in a relatively unbiased way, and are based on measured variables that relate to asthma symptoms (26) and/or biomarkers such as bronchial hyperresponsiveness and atopy (27, 28).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [26]
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Epidemiology of Asthma in Children and Adults
Dharmage, S. C., Perret, J. L., & Custovic, A. (2019) · Frontiers in Pediatrics · doi:10.3389/fped.2019.00246 · Cited by 1,200 · see citing works
- Authors
- Mäkikyrö, E. M. S., Jaakkola, M. S., & Jaakkola, J. J. K.
- Affiliations
- University of Oulu (FI)
- Corresponding author
- Jaakkola, Jouni J. K.
- Venue
- Respiratory Research
- Published
- 2017-01-23
- Volume
- 18
- Issue
- 1
- Pages
- 24-24
- ISSN
- 1465-9921 (ISSN-L)
- 1465-993X
- PMC
- PMC5259948
- OpenAlex
- W2580242289
- Cited by
- 22
- References
- 39
- Citations by year
- 2025: 4 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 2
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Respiratory Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Emil Aaltosen Säätiö
- Research Foundation of the Pulmonary diseases
- The Väinö and Laina Kivi Foundation
- Finnish Anti-Tuberculosis Association
- Terveyden Tutkimuksen Toimikunta (266314)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- asthma subtypes, asthma control, asthma severity, latent class analysis, St George's Respiratory Questionnaire, asthma medication use, sex differences
- MeSH terms
- Adolescent, Adult, Aged, Asthma, Finland, Humans, Middle Aged, Surveys and Questionnaires, Sensitivity and Specificity, Severity of Illness Index, Reproducibility of Results, Prevalence, Multivariate Analysis, Sex Distribution, Young Adult, Symptom Assessment
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