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Thursday, November 1, 2012

Modeling asthma-related utilization


In the current socioeconomic climate, evaluating healthcare utilization in the context of chronic disease outcomes and intervention is vital. Think Framingham. Wu et al. in this month’s issue (J Allergy Clin Immunol 2012;130:1065-1070) step up to this challenge for asthma, designing and testing a prediction model that draws on data from the Childhood Asthma Management Program (CAMP). The authors use data on changes in prebronchodilator FEV1 % predicted in subjects treated with ICS to simulate prediction of hospitalization, ED visits, and oral CS therapy associated with exacerbations. The simulated results are then compared with the actual data from CAMP to assess the model’s reliability.

Wu et al. report remarkable consistency between the simulation predictions and the CAMP data. As one example, their model predicted a 48% decrease in hospitalizations with ICS therapy compared to placebo. The observed decrease in the CAMP data was 49%. The authors comment that further testing with data not involved in developing the model is required and they invite other asthma investigators to collaborate. 

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