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Asking the Correct Questions to Assess Asthma Symptoms

Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan Health System, Ann Arbor, Michigan

Kathryn K. Slish, MA

Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan Health System, Ann Arbor, Michigan

Bin Nan, PhD

Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan

Xihong Lin, PhD

Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan

Noreen M. Clark, PhD

Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan Health System, Department of Biostatistics Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan

A national survey of 896 parents of children with asthma was performed and responses to 2 types of inquiry were compared: global assessment versus specific assessment of symptoms. Almost all parents, 860 (96%), described their child’s asthma as under "good control" when asked a global assessment question. However, 306 (34%)—when asked specific questions—actually described poor asthma control with frequent symptoms. Medicaid insurance (OR: 1.59; 95% CI: 1.03, 2.44) and parental smoking (OR: 1.60; 95% CI: 1.06, 2.43) increased the likelihood that parents’ responses would be at risk for misinterpretation. Increased education (OR 0.41: 95% CI: 0.18, 0.91) and English as the primary language (OR 0.39; 95% CI 0.16, 0.96) were associated with decreased likelihood of misinterpretation. Vague, global assessment questions lead to incomplete clinical information and places the patient at risk for inadequate asthma therapy. A better approach is to use specific questions to determine the frequency of daytime or nighttime symptoms.

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