A Delphi approach to the development of standard questionnaire to investigate asthma in Koreans

Jaewoo An; Kyung Suk Lee; Jin Tack Kim; Hyeon-Jong Yang; You Sook Cho; Kwang Cheon Jang; Woo-Jung Song; Hyouk-Soo Kwon; Jong Seo Yoon; Man Yong Han

doi:10.4168/aard.2018.6.1.34

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An, Lee, Kim, Yang, Cho, Jang, Song, Kwon, Yoon, and Han: A Delphi approach to the development of standard questionnaire to investigate asthma in Koreans

Original Article

Allergy Asthma Respir Dis 2018;6(1):34-40.

Published online: 5 January 2018

DOI: https://doi.org/10.4168/aard.2018.6.1.34

A Delphi approach to the development of standard questionnaire to investigate asthma in Koreans

Jaewoo An¹, Kyung Suk Lee¹, Jin Tack Kim², Hyeon-Jong Yang³, You Sook Cho⁴, Kwang Cheon Jang⁵, Woo-Jung Song⁶, Hyouk-Soo Kwon⁴, Jong Seo Yoon², Man Yong Han¹

¹Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea

²Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea

³Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea

⁴Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

⁵Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

⁶Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

Correspondence to: Man Yong Han https://orcid.org/0000-0002-9077-5779 Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea Tel: +82-31-780-6262, Fax: +82-31-780-5239, E-mail: drmesh@gmail.com

• This research was supported by fund 2015-P66002-00 by Research of Korea Centers for Disease Control and Prevention.

Received 14 June 20178 August 2017 Accepted 14 August 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Recently, the prevalence and disease burden of asthma have increased. Thus, the need for early diagnosis and appropriate management of asthma is emerging. However, it is difficult to identify the diagnosis, symptoms and the prevalence of asthma due to lack of reliable investigating items. The purpose of this study was to develop a standardized survey format in order to assess the prevalence of asthma in Koreans.

Methods

We investigated surveys and related information that are utilized to assess asthma diagnosis and prevalence by systematic review. After that, Delphi survey was conducted on 44 Korean allergists in order to develop a standardized survey in Korea. The process consisted of 3 serial rounds across 3 age groups. Each subsequent round narrowed investigating items for the decision of standard set about asthma prevalence, current asthma, and asthma aggravation.

Results

Lifetime asthma was defined as “ ever doctor-diagnosed asthma” in all age groups. Current asthma was defined as “ treatment for asthma during the past 12 months” in all age groups, and “ doctor-diagnosed asthma during the past 12 months” was added on the ≥5-year-old and adult groups. “ Wheezing ever” was defined as “ wheezing at any time in the past,” and current wheeze was defined as “ wheezing in the last 12 months.” Asthma aggravation was defined as “ visits at the emergency department or admission due to asthma attack within the last 12 months” in all age groups.

Conclusion

We established applicable nationwide definitions of “ lifetime asthma,” “ current asthma,” and “ asthma aggravation” in Koreans by the Delphi survey.

Keywords: Asthma, Questionnaire, Delphi

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Fig. 1.

Flowsheet of survey of questionnaires through systematic review.

Table 1.

Items selected in the first Delphi survey

	Item	4-, 5-point response (%)
Under 5 years
Lifetime asthma	Doctors' diagnosis of asthma since birth	85
	Presence and frequency of wheezing since birth	60
	Diagnosis of asthma and presence of wheezing since birth	60
Current asthma	Doctors' diagnosis of asthma since birth	85
	Whether asthma treatment	70
	Presence and frequency of wheezing	60
	Diagnosis and presence of wheezing	70
Asthma exacerbation	Visits to the emergency room due to asthma exacerbation	60
	The presence and frequency of visits to the Emergency Department due to asthma exacerbation	85
	Whether or not hospitalized due to asthma exacerbations	95
5 Years old or older
Lifetime asthma	Whether asthma diagnosis	85
	Whether asthma diagnosis and treatment	60
	Diagnosis of asthma and presence of wheezing	60
Current asthma	Whether or not the doctor is diagnosed	75
	Whether asthma treatment	80
	Diagnosis and treatment	60
	Whether it is wheezing	60
	Presence and frequency of wheezing	65
	Diagnosis and presence of wheezing	75
Asthma exacerbation	Visits to the emergency room due to asthma exacerbation	75
	The presence and frequency of visits to the Emergency Department due to asthma exacerbation	95
	Whether or not hospitalized due to asthma exacerbations	95
Adult
Lifetime asthma	Asthma diagnosis and treatment	83
Current asthma	Whether asthma medication was used	75
Asthma exacerbation	Visits to the emergency room due to asthma	75
	The presence and frequency of visits to the Emergency Department due to asthma	88
	Whether to visit the emergency room due to wheezing	63

Table 2.

The final selection questionnaires in the Delphi survey

Item	Questionnaires
Under 5 years
Diagnosis & current asthma	Has your child ever been diagnosed with asthma by your doctor since birth?
Diagnosis & current asthma	- If so, did your child have been treated for asthma in the last 12 months?
Wheezing & count	From birth to now, have you ever heard a wheezing or whistling from your child's chest when your child breathed?
	- If so, has your child been wheezing or whistling in your child's chest in the last 12 months? Yes, No
	- If yes, how many times have your child been in the last 12 months? ____ times
Asthma exacerbation	Has your child ever visited an emergency room or hospitalized in the last 12 months with asthma exacerbations?
Asthma exacerbation	- If so, how many times have your child been in the last 12 months?
5 Years old or older
Diagnosis & current asthma	Have your child ever been diagnosed with asthma by your doctor since birth?
Diagnosis & current asthma	- If so, did your child have been treated for asthma in the last 12 months?
Asthma exacerbation	Has your child ever visited an emergency room or hospitalized in the last 12 months with asthma exacerbations?
Asthma exacerbation	- If so, how many times have your child been in the last 12 months?
Adult
Lifetime asthma	Have you ever been diagnosed and treated for asthma by birth?
Current asthma	Are you currently taking medication for asthma treatment? (Inhalant, spray or oral medicines)
	Have you ever used a therapeutic inhalant for asthma in the last 12 months?
	Have you ever had wheezing or whistling in your chest in the last 12 months?
Asthma exacerbation	Have you ever visited an emergency room, hospitalized, or an unscheduled outpatient visit in the last 12 months with asthma exacerbations?
	- If so, how many times have you been in the last 12 months?
	Have you ever used first aid medication (Oral or injectable steroid) for asthma exacerbations in the last 12 months?

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