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BMC Primary Care
Published in: BMC Primary Care 1/2004

Open Access 01-12-2004 | Research article

Development of a questionnaire weighted scoring system to target diagnostic examinations for asthma in adults: a modelling study

Authors: Sybil Hirsch, Timothy L Frank, Jonathan L Shapiro, Michelle L Hazell, Peter I Frank

Published in: BMC Primary Care | Issue 1/2004

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Abstract

Background

Identification and treatment of unrecognised asthmatics in the community is important for improving the health of the individual and minimising cost and quality of life burden. It is not practical to offer clinical diagnostic assessment to whole communities, and a simple tool such as a questionnaire is required to identify a smaller target group. Conventional questionnaire screening methods which separate individuals into positive and negative categories have resulted in large numbers of individuals requiring clinical assessment. This study has therefore developed and tested a weighted scoring system that prioritises those most urgently in need, based on their questionnaire responses.

Methods

A stratified random sample of adult respondents to a general practice postal questionnaire survey were categorised 'asthmatic' or 'non-asthmatic' according to three expert physicians' opinions. Based on this categorisation, logistic regression was used to derive weights reflecting the relative importance of each question in predicting asthma, allowing calculation of weighted scores reflecting likelihood of asthma. Respondents scoring higher than a chosen threshold would be offered diagnostic examination.

Results

Age and presence of wheeze were most influential (weight 3) and overall weighted scores ranged from -1 to 13. Positive predictive values (PPV) were estimated. For example, setting the threshold score at nine gave an estimated PPV for asthma diagnosis of 93.5%, a threshold score of seven corresponded to PPV 78.8%. PPV estimates were supported by examining 145 individuals from a new survey.

Conclusion

Weighted scoring of questionnaire responses provides a method for evaluating the priority level of an individual 'at a glance', minimising the resource wastage of examining false positives.
Appendix
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Metadata
Title
Development of a questionnaire weighted scoring system to target diagnostic examinations for asthma in adults: a modelling study
Authors
Sybil Hirsch
Timothy L Frank
Jonathan L Shapiro
Michelle L Hazell
Peter I Frank
Publication date
01-12-2004
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2004
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-5-30

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