{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:16:49Z","timestamp":1769084209927,"version":"3.49.0"},"reference-count":23,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"AstraZeneca, Portugal"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,9,26]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The A2 score is an eight-question patient-reported outcome measure that has been validated for ruling in (score \u22654) and ruling out (score 0\u20131) asthma. However, this screening tool has been validated in a cohort similar to the derivation cohort used. This study aims to validate the predictive accuracy of the A2 score in a primary care population against general practitioner (GP) clinical assessment and to determine whether the proposed cut-offs are the most appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This accuracy study is a secondary analysis of the EPI-ASTHMA population-based study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care centres in Portugal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Random adult participants answered the A2 score by phone interview.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Those with an A2 score \u22651 (plus 5% with an A2 score of 0) were invited to a diagnostic visit carried out by a GP to confirm or not a diagnosis of asthma. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1283 participants (median 54 (p25\u2013p75 43\u201366) years; 60% women) were analysed. The A2 score showed high discriminatory power in identifying asthma, with an area under the ROC curve of 82.9% (95% CI 80.4% to 85.4%). The proposed cut-off \u22654 was the most appropriate to rule in asthma (specificity 83.1%, positive predictive value 62.4%, accuracy 78%). Similarly, the proposed cut-off&lt;2 was the most suitable for excluding asthma (sensitivity 92.7%, negative predictive value 93.7%, accuracy 60.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The A2 score is a useful tool to identify patients with asthma in a primary care population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT0516961\">NCT0516961<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086493","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T23:07:06Z","timestamp":1730588826000},"page":"e086493","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Validation of the adult asthma epidemiological score: a secondary analysis of the EPI-ASTHMA population-based study"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct0516961","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05169619","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8974-8631","authenticated-orcid":false,"given":"Catarina","family":"Laranjeira","sequence":"first","affiliation":[{"name":"University of Porto Faculty of Medicine, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-8791","authenticated-orcid":false,"given":"Cristina","family":"J\u00e1come","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, Department of Community Medicine, Information and Health Decision25 Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0233-830X","authenticated-orcid":false,"given":"Rita","family":"Amaral","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, Department of Community Medicine, Information and Health Decision25 Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal"},{"name":"Department of Women's and Children's Health, Pediatric Research, Uppsala University, Uppsala, Sweden"}]},{"given":"Filipa","family":"Bernardo","sequence":"additional","affiliation":[{"name":"AstraZeneca, Queluz, Lisbon, Portugal"}]},{"given":"Jaime","family":"Correia-de-Sousa","sequence":"additional","affiliation":[{"name":"University of Minho, Life and Health Sciences Research Institute (ICVS)\/3B\u2019s\u2014PT Government Associate Laboratory, Braga, Portugal"}]},{"given":"Joao A","family":"Fonseca","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, Department of Community Medicine, Information and Health Decision25 Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"MEDIDA, Porto, Portugal"},{"name":"Allergy Unit, Hospital and Institute CUF, Porto, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2024,11,2]]},"reference":[{"key":"2025120518151177000_14.11.e086493.1","unstructured":"Global Initiative for Asthma \u2013 GINA . 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