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Pediatr Allergy Immunol. 2012 Sep;23(6):537-42. doi: 10.1111/j.1399-3038.2012.01316.x. Epub 2012 May 25.

Breathlessness perception assessed by visual analogue scale and lung function in children with asthma: a real-life study.

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Pediatric Pulmonology and Allergy Unit, Istituto Giannina Gaslini, Genoa, Italy.



In children with asthma, discrepancies between objective indicators of airway obstruction and symptom perception are often observed. Although visual analogue scale (VAS) has been proposed as a useful tool for assessing accurate symptom perception, previous studies conducted in children with asthma included only small cohorts. A study was therefore designed to investigate the usefulness of VAS in establishing a reliable relationship between breathlessness perception and lung function in a large cohort of children with clinical diagnosis of asthma.


A total of 703 children [470 boys and 233 girls, median age 10.29 (8.33-12.58) yr] with asthma were included in this cross-sectional, real-life study. Perception of breathlessness was assessed by using VAS, and lung volumes and expiratory flows were measured by spirometry.


Most children had intermittent or mild persistent asthma (93.3%), and only 46 children had a significant bronchial obstruction defined by FEV(1) values <80% of predicted. Globally, VAS was significantly, even though weakly, related to lung function. Analyzing children with bronchial obstruction, a moderate relationship between both FEV(1) (r = 0.47) and FEF(25-75) (r = 0.42) and VAS was detected. A VAS value of 6 was found to be a reliable cutoff for discriminating children with bronchial obstruction (AUC 0.83 at ROC curve; OR 9.4).


The present study demonstrates that VAS might be considered a useful tool to assess symptom perception, mainly in children with airflow limitation.

[Indexed for MEDLINE]

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