Researchers from CINTESIS – Center for Health Technology and Services Research are proposing an improvement in the classification of respiratory allergic disease subtypes (phenotypes), such as asthma, which affects about 700,000 people in Portugal.
The work, entitled “Disentangling the heterogeneity of allergic respiratory diseases by latent class analysis reveals novel phenotypes” and published in the prestigious scientific journal Allergy, aims to better characterize the individual profile of each patient and contribute to the customization of prevention and treatment strategies.
One of the main novelties of the new classification is the inclusion of eye symptoms, such as tearing and itching of the eye, as true “warning signs” and are essential in identifying the different subtypes of allergic respiratory disease.
“Eye symptoms may be present in different forms of allergic respiratory disease but they affect mostly patients with more severe forms. However, these symptoms are often undervalued by both professionals and patients.” says the Rita Amaral, researcher from CINTESIS and first author of the study coordinated by João Fonseca, principal investigator at CINTESIS and director of the Department of Community Medicine, Health Information and Decision (MEDCIDS) of the Faculty of Medicine of the University of Porto (FMUP).
The researchers also propose to abandon the one-size-fits-all logic and favor a logic of “multimorbidity”, which considers not only the coexistence of several related diseases in the same person, but also the possible interactions and links between underlying pathophysiological mechanisms.
To reach these conclusions, scientists used data science techniques, including data mining “data-driven” techniques and approaches (unsupervised data analysis), stressing the importance of advanced mathematics applied to medicine, as conventional approaches to classifying/stratifying asthma often “fail” to identify more complex subtypes.
The authors recommend conducting longitudinal studies in the future that include daily patient data, such as disease registry data like the Registo de Asma Grave (asmagrave.com), which facilitate the collection, monitoring and sharing of patients data, and data collected in mobile applications, increasingly popular with the general public, patients and clinicians.
Asthma is a major public health problem worldwide that affects people of all ages and imposes considerable costs on healthcare systems, patients and their families. According to another study coordinated by João Fonseca, it is estimated that asthma costs the Portuguese State about 550 million euros per year – 929 euros per child and 708 euros per adult; costs that double when referring to patients with uncontrolled asthma.