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Article

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

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Westat, Rockville, MD 20850, USA
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Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA
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Dartmouth Institute for Health Policy and Clinical Practice, The C. Everett Koop Institute at Dartmouth, The Lisa Schwartz Foundation, Lebanon, NH 03766, USA
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Moores Cancer Center, University of California at San Diego, La Jolla, CA 92037, USA
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Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
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School of Global Public Health, New York University, New York, NY 10012, USA
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Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA
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National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20852, USA
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Department of Psychiatry & Behavioral Science, Medical University of South Carolina, Mt. Pleasant, SC 29464, USA
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Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(18), 9688; https://doi.org/10.3390/ijerph18189688
Received: 29 July 2021 / Revised: 9 September 2021 / Accepted: 10 September 2021 / Published: 14 September 2021
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. View Full-Text
Keywords: tobacco use; respiratory health; wheeze; functional outcomes; patient-reported outcomes; PATH Study tobacco use; respiratory health; wheeze; functional outcomes; patient-reported outcomes; PATH Study
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MDPI and ACS Style

Halenar, M.J.; Sargent, J.D.; Edwards, K.C.; Woloshin, S.; Schwartz, L.; Emond, J.; Tanski, S.; Pierce, J.P.; Taylor, K.A.; Lauten, K.; Goniewicz, M.L.; Niaura, R.; Anic, G.; Chen, Y.; Callahan-Lyon, P.; Gardner, L.D.; Thekkudan, T.; Borek, N.; Kimmel, H.L.; Cummings, K.M.; Hyland, A.; Brunette, M.F. Validation of an Index for Functionally Important Respiratory Symptoms among Adults in the Nationally Representative Population Assessment of Tobacco and Health Study, 2014–2016. Int. J. Environ. Res. Public Health 2021, 18, 9688. https://doi.org/10.3390/ijerph18189688

AMA Style

Halenar MJ, Sargent JD, Edwards KC, Woloshin S, Schwartz L, Emond J, Tanski S, Pierce JP, Taylor KA, Lauten K, Goniewicz ML, Niaura R, Anic G, Chen Y, Callahan-Lyon P, Gardner LD, Thekkudan T, Borek N, Kimmel HL, Cummings KM, Hyland A, Brunette MF. Validation of an Index for Functionally Important Respiratory Symptoms among Adults in the Nationally Representative Population Assessment of Tobacco and Health Study, 2014–2016. International Journal of Environmental Research and Public Health. 2021; 18(18):9688. https://doi.org/10.3390/ijerph18189688

Chicago/Turabian Style

Halenar, Michael J., 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. M. Cummings, Andrew Hyland, and Mary F. Brunette 2021. "Validation of an Index for Functionally Important Respiratory Symptoms among Adults in the Nationally Representative Population Assessment of Tobacco and Health Study, 2014–2016" International Journal of Environmental Research and Public Health 18, no. 18: 9688. https://doi.org/10.3390/ijerph18189688

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