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Table 3 Categories for classifying potential cases selected for chart review

From: A longitudinal study of adult-onset asthma incidence among HMO members

Classification of Asthma Severity
  Symptoms Night time Symptoms Lung Function Chart Review
Mild Intermittent • Symptoms ≤ 2 times/week ≤ 2 times a month • FEV1 or PEF ≥ 80% predicted Asthma not mentioned in visits that are routine (i.e. physical exam) or for other medical problems. Does not refill asthma medications regularly.
  • Asymptomatic and normal PEF between exacerbations   • PEF variability < 20%  
  • Exacerbations brief (from a few hours to a few days); intensity may vary    
Mild Persistent • Symptoms > 2 times a week but < 1 time a day > 2 times a month • FEV1 or PEF ≥ 80% predicted Asthma mentioned in some of the "non-asthma" visits. Asthma meds refilled regularly. Exacerbation may require systemic steroids.
  • Exacerbations may affect activity   • PEF variability 20–30%  
Moderate Persistent • Daily Symptoms > 1 time a week • FEV1 or PEF >60% -<80% predicted Asthma is a common reason for visits. Uses inhaled steroids regularly. Uses systemic steroids intermittently, but more than once a year in most years.
  • Daily use of inhaled short-acting beta2-agonist   • PEF variability >30%  
  • Exacerbations affect activity    
  • Exacerbations ≥ 2 times a week; may last days    
Severe Persistent • Continual symptoms Frequent • FEV1 or PEF ≤ 60% predicted Asthma always a problem. Systemic steroids frequently or continuously. Hospitalizations.
  • Limited physical activity   • PEF variability >30%  
  • Frequent exacerbations    
  1. Adapted from NHLBI "Guidelines for the diagnosis and management of asthma". NIH publication number 97-4051, July 1997.