Asthma severity is variable and unpredictable

albuterol use 6.0 days per week and 4.7 days per week, respectively. However, the percent of weeks the subjects in these studies met criteria for intermittent, mild, moderate or severe asthma were 9.2 percent, 13.6 percent, 71.1 percent and 6.1 percent of weeks, respectively. These data were based on symptom scores, peak expiratory flow and albuterol use.

"The data demonstrate that asthma not controlled with maintenance medications can be a variable and unpredictable disease, with severity that changes from week to week," said Paul Dorinsky, MD, the study's lead author. "Physicians should recognize that asthma that may initially be thought to be 'mild,' frequently becomes more severe if these patients are followed over time."

No one parameter reliably predicted overall severity for individual patients at any given point in time. Failure to take this into consideration could possibly result in either an underestimation or overestimation of asthma severity.

Asthma is a chronic lung disease. Both inflammation (swelling and irritation) and constriction (tightening of the muscles around the airways) cause the airways to narrow, leading to symptoms that include cough, wheezing, shortness of breath and chest tightness. Though there is no cure, advances in research and preventative treatments in the past decade have made asthma a more controllable condition.

Yet, for many of the 24.7 million Americans who have been diagnosed with asthma at some point in their lives,2 the disease remains out of control. Each year, asthma accounts for approximately 5,000 deaths,2 500,000 hospitalizations,3 two million emergency department visits,2 14 million missed school days4 and 14.5 million missed work days.4 In 2000, asthma cost the U.S. economy an estimated $14 billion.5

According to national and international treatment guidelines, patients with persistent asthma can be classified into one of three categories (mild, moderate or severe) based


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