Title: Study of Correlation between Visual Analogue Scale and Peak Expiratory Flow Rate Measurement to Assess Severity of Bronchial Asthma
Authors: Toke SK, Singh RB
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.134
Abstract
Bronchial asthma is a chronic inflammatory disorder of the airways. Asthma patient experiences symptoms like cough, dyspnea, wheeze, chest tightness. Dyspnea is often used as a marker of severity of asthma. The severity of bronchial asthma is best judged by spirometry using parameters like FEV1 and PEFR. In rural areas spirometry assessment is difficult because of limited access to medical facilities, lack of or interrupted supply of electricity, unavailability of trained technician and poverty. Visual analogue scale (VAS) is a tool used to help a person to rate the intensity of certain feelings & sensations. Severity of dyspnea can be assessed by visual analogue scale. After explaining study and taking written informed consent, 100 bronchial asthma patients having age more than 18 years were selected randomly. We divided the patients in three groups according to FEV1as mild, moderate and severe.VAS chart was handed over to patients. Each patient was asked to mark in the chart according to his/her dyspnea. PEFR was measured immediately after recording of VAS using mini peak flow meter. At each instance three recordings were taken with thirty seconds interval & best reading was used for analysis.
All mild, moderate and severe asthma groups showed strongly significant correlation between visual analogue scale and PEFR (Pearson r = -0.8472). There was strong correlation between visual analogue scale and FEV1 (Pearson r = -0.7157) in asthma patients. This study also showed strong correlation between PEFR and FEV1 in moderate and severe groups of asthma patients. We conclude that visual analogue scale can be a used to assess severity of bronchial asthma except in poor perceivers of symptoms.
Keywords: Visual analogue scale (VAS), PEFR.
References
- Maroli M, Fabian D, Holt S, Beasley R. The Global burden of Bronchial Asthma Executive summary of the GINA dissemination committee report. Allergy. 2004; 59(5): 469-78.
- South Asia Network for chronic Disease. New Delhi, India: 2010. Available from: http//www.sancd.org/uploads/pdf/Asthma_factsheet.pdf ..
- Lai CK, De Guria TS, Kim YY, Kuo SH, Mukhopadhyay A, et al. Bronchial Asthma Control in Asia-Pacific region; the Bronchial Asthma Insights and Reality in Asia – Pacific study. J Allergy ClinImmunol. 2003; 111 (2): 263-8.
- Boulet LP. Asymptomatic airway hyper responsiveness: a curiosity or an opportunity to prevent Bronchial Asthma. Am J Respir Crit Care Med. 2003; 167(3): 371-8.
- Killian KJ, Watson R, Otis J, St Amand TA, O’Byrne Symtom perception during acute bronchoconstriction. Am J Respir Crit Med. 2000; 162 (2Pt 1): 490-6.
- Haefeli M, Elfering A. Pain assessment European Spine Journal. 2006;15(Suppl 1):S17-S24.doi:10.1007/s00586-005-1044-x.
- Taube C, Lehnigk B, Paasch K, Kirsten DK, Jörres RA, Magnussen H. Factor Analysis of Changes in Dyspnea and Lung Function Parameters after Bronchodilation in Chronic Obstructive Pulmonary Disease.Am J Respir Crit Care Med. 2000 Jul;162(1):216-20
- Koshak EA. Classification of asthma according to revised 2006 GINA: Evolution from severity to control. Annals of Thoracic Medicine. 2007;2(2):45-46. doi:10.4103/1817-1737.32228.
- Gupta D. Aggarwal A.et al . Assessing severity of asthma: Spirometric correlates with Visual Analogue Scale (VAS).Indian Journal of Chest dis allied Sci. 2000;42:95-100.
- Guleria R, Behera D, Jindal SK. Correlation of lung function tests with dyspnea scale:12-minute walking test and visual analogue scale in patients with COPD. Indian J Chest Dis Allied Sci. 1989;31: 241-245.