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RE: Severity and Control Assessment in EPR-3

clramos — Wed, 26 Mar 2008 12:01:29 GMT

Lani,

Thank you for clarification of the night time symptoms as well? We have had providers ask us this definition and that is traditionally what we have said as well-waking up with cough, chest tightness, shortness of breath, etc. Nice to know we weren't too off target.

Candace Ramos, RRT, AE-C

RE: Severity and Control Assessment in EPR-3

laniwheeler — Tue, 18 Mar 2008 07:59:57 GMT

David,

I checked with Virginia Taggart at NHLBI and she replied:

1) The figures on severity and control distinguish between symptoms during the day and

2) nighttime awakenings

A symptom at night would presumably lead to a nighttime awakening. I'm aware that many children cough at night without waking up...but the waking up with symptoms appears to be the stronger signal. This could be one of those areas where clinician judgement of individual patient circumstances really helps-

Severity and Control Assessment in EPR-3

dnunez — Tue, 18 Mar 2008 07:30:01 GMT

I'm wondering if you could share your insights on a question that we have regarding severity and control assessment in EPR-3.

Under the symptoms component, is the frequency of symptoms specified for each severity level referring only to daytime symptoms? This would be consistent with the daytime symptom frequency categories in the 2002 Update. Unfortunately, there is no specification indicated in EPR-3 as to whether this includes both day and night symptoms.

A second related question: For the nighttime awakenings component, it seems that the research evidence is mostly based upon episodes of actual awakenings, but are we only concerned with awakenings, or should we also be including episodes of nighttime cough in this measure?

Many thanks,

David