Using the past to predict the future
Management of asthma includes risk evaluation of future exacerbations. Intuitively, a clinician makes use of the patient’s past history to assess future risk, but there are currently no objective ways to do this.
In a study published in the February 2011 issue of The Journal of Allergy and Clinical Immunology (JACI), Dr. Thamrin and colleagues have proposed a method to calculate probability of future asthma exacerbations in individual patients, based on twice-daily electronic monitoring of peak expiratory flow. It determines the occurrence of drops in lung function during a past reference period, and uses this information to calculate the probability of exacerbations in the future, given current lung function. Once the reference is established, a patient can obtain an updated percentage probability of an exacerbation occurring within the month each time he/she blows a new peak flow value. This is all done at home, allowing both patient and clinician an objective assessment of the need for a clinic visit or intervention in the near future.
The method predicted clinical exacerbations in two independent datasets, and remains to be validated in a prospective study, but it is also potentially applicable to other measures such as inflammatory markers. This is the first time past history has been objectively quantified and put to practical use, and is a step towards personalised medicine.
10-0694, Predicting future risk of asthma exacerbations using individual conditional probabilities
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.