Abstract
The definition of asthma has always been a matter of discussion. The European Community
Respiratory Health Survey (ECRHS) is a multinational survey designed to compare the
prevalence of asthma in subjects aged 20 to 44 years throughout European countries.
In each center a representative sample completed a self-administered screening questionnaire
composed of nine dichotomous items. We propose a method for constructing a score for
the ECRHS screening questionnaire and we validate the method with reference to the
clinical diagnosis available for the Italian centers. Clinical diagnosis was made
by a group of medical experts after examining the responses to a standardized clinical
interview, respiratory function tests, and allergy tests. Before constructing a summary
score, the number of latent factors/dimensions explaining correlations among the observed
items was recognized. We identified only one factor/dimension underlying the screening
questionnaire, so a summary score was determined by the Homogeneity Analysis by Alternating
Least Square (HOMALS). Using best Receiver Operating Characteristic (ROC) threshold
the diagnostic test of the score had sensitivity and specificity of 75.1 and 80.1%,
respectively. The method of scoring is easily reproducible, and has the advantage
of optimizing information recoded by the questionnaire.
Keywords
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Article info
Publication history
Accepted:
November 20,
2002
Received in revised form:
November 15,
2002
Received:
June 20,
2001
Identification
Copyright
© 2003 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.