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RESEARCH ARTICLE

Temporal Asthma Patterns Using Repeated Questionnaires over 13 Years in a Large French Cohort of Women

• Margaux Sanchez mail,
 
• Jean Bousquet,
 
• Nicole Le Moual,
 
• Bénédicte Jacquemin,
 
• Françoise Clavel-Chapelon,
 
• Marc Humbert,
 
• Francine Kauffmann,
• Pascale Tubert-Bitter,
 
• Raphaëlle Varraso

• Abstract

  Variable expression is one aspect of the heterogeneity of asthma. We aimed to define a variable pattern, which is relevant in general health epidemiological cohorts. Our objectives were to assess whether: 1) asthma patterns defined using simple asthma questions through repeated measurements could reflect disease variability 2) these patterns may further be classified according to asthma severity/control. Among 70,428 French women, we used seven questionnaires (1992–2005) and a comprehensive reimbursement database (2004–2009) to define three reliable asthma patterns based on repeated positive answers to the ever asthma attack question: “never asthma” (n = 64,061); “inconsistent” (“yes” followed by “no”, n = 3,514); “consistent” (fully consistent positive answers, n = 2,853). The “Inconsistent” pattern was related to both long-term (childhood-onset asthma with remission in adulthood) and short-term (reported asthma attack in the last 12 months, associated with asthma medication) asthma variability, showing that repeated questions are relevant markers of the variable expression of asthma. Furthermore, in this pattern, the number of positive responses (1992–2005) predicted asthma drug consumption in subsequent years, a marker of disease severity. The “Inconsistent” pattern is a phenotype that may capture the variable expression of asthma. Repeated answers, even to a simple question, are too often neglected.

  Citation: Sanchez M, Bousquet J, Le Moual N, Jacquemin B, Clavel-Chapelon F, et al. (2013) Temporal Asthma Patterns Using Repeated Questionnaires over 13 Years in a Large French Cohort of Women. PLoS ONE 8(5): e65090. doi:10.1371/journal.pone.0065090

  • Abstract
  • Introduction
  • Materials and Methods
  • Results
  • Discussion
  • Supporting Information
  • Acknowledgments
  • Author Contributions
  • References

  • Reader Comments (0)
  • Figures

  Editor: Monica da Silva Nunes, Universidade Federal do Acre (Federal University of Acre), Brazil

  Received: December 4, 2012; Accepted: April 20, 2013; Published: May 31, 2013

  Copyright: © 2013 Sanchez et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  Funding: The E3N study is supported by the Mutuelle Générale de l’Education Nationale (MGEN), the European Community, the French League against Cancer (LNCC), the Gustave Roussy Institute (IGR), the National Institute for Health and Medical Research (Inserm) and General Councils of France. The specific respiratory health survey in the E3N study was supported by the Fonds de dotation “Recherche en Santé Respiratoire”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  Competing interests: The authors have declared that no competing interests exist.