Table 3 Categories for classifying potential cases selected for 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