Evidence map›Paper›PMID 30662273›Full record

ArticleJournal of asthma and allergy2019

Clinical profile of predefined asthma phenotypes in a large cohort of UK primary care patients (Clinical Practice Research Datalink).

Francis Nissen, Ian J Douglas, Hana Müllerová, Neil Pearce, Chloe I Bloom, Liam Smeeth, Jennifer K Quint

Open access · goldAbstract read
In one paragraph

Article in Journal of asthma and allergy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Francis NissenDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK, francis.nissen@lshtm.ac.uk.
Ian J DouglasDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK, francis.nissen@lshtm.ac.uk.
Hana MüllerováRWD & Epidemiology, GSK R&D, Uxbridge, UK.
Neil PearceDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK, francis.nissen@lshtm.ac.uk.
Chloe I BloomNational Heart and Lung Institute, Imperial College, London, UK.
Liam SmeethDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK, francis.nissen@lshtm.ac.uk.
Jennifer K QuintNational Heart and Lung Institute, Imperial College, London, UK.
London School of Hygiene & Tropical Medicine · GBImperial College London · GBAge UK · GB

Funding

Medical Research Council G0802403
6 · The paper itself

Abstract

backgroundDistinct asthma phenotypes have previously been suggested, including benign asthma, atopic asthma and obese non-eosinophilic asthma. This study aims to establish if these phenotypes can be identified using data recorded in primary care clinical records and reports on patient characteristics and exacerbation frequency.

methodsA population-based cohort study identified 193,999 asthma patients in UK primary care from 2007 to 2017. We used linked primary and secondary care data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics. Patients were classified into predefined phenotypes or included in an asthma "not otherwise specified" (NOS) group. We used negative binomial regression to calculate the exacerbation rates and adjusted rate ratios. Rate ratios were further stratified by asthma treatment step.

resultsIn our cohort, 3.9% of patients were categorized as benign asthma, 28.6% atopic asthma and 4.8% obese non-eosinophilic asthma. About 62.7% of patients were asthma NOS, including asthma NOS without treatment (10.4%), only on short-acting beta agonist (6.1%) and on maintenance treatment (46.2%). Crude severe exacerbation rates per 1,000 person-years were lowest for benign asthma (106.8 [95% CI: 101.2-112.3]) and highest for obese non-eosinophilic asthma (469.0 [451.7-486.2]). Incidence rate ratios for all phenotype groups decreased when stratified by treatment step but remained raised compared to benign asthma.

conclusionEstablished phenotypes can be identified in a general asthma population, although many patients did not fit into the specific phenotypes which we studied. Phenotyping patients and knowledge of asthma treatment step could help anticipate clinical course and therefore could aid clinical management but is only possible in a minority of primary care patients based on current phenotypes and electronic health records (EHRs).

Indexed as

asthmaelectronic health recordsepidemiologyphenotypesphenotypingprimary health care

Identifiers

PMID30662273
PMCPMC6329349
OpenAlexW2908265437

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.