Cutoff values of MASK-air patient-reported outcome measures

Bernardo Sousa-Pinto, Ana Sá-Sousa, Rafael José Vieira, Rita Amaral, Ana Margarida Pereira, Josep M. Anto, Ludger Klimek, Wienczyslawa Czarlewski, Joaquim Mullol, Oliver Pfaar, Anna Bedbrook, Luisa Brussino, Violeta Kvedariene, Desirée E. Larenas-Linnemann, Yoshitaka Okamoto, Maria Teresa Ventura, Ignacio J. Ansotegui, Sinthia Bosnic-Anticevich, G. Walter Canonica, Victoria CardonaLorenzo Cecchi, Tomas Chivato, Cemal Cingi, Elísio M. Costa, Alvaro A. Cruz, Stefano Del Giacco, Philippe Devillier, Wytske J. Fokkens, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Piotr Kuna, Igor Kaidashev, Helga Kraxner, Daniel Laune, Renaud Louis, Michael Makris, Riccardo Monti, Mario Morais-Almeida, Ralph Mösges, Marek Niedoszytko, Nikolaos G. Papadopoulos, Vincenzo Patella, Nhân Pham-Thi, Frederico S. Regateiro, Sietze Reitsma, Philip W. Rouadi, Boleslaw Samolinski, Aziz Sheikh, Milan Sova, Luis Taborda-Barata, Sanna Toppila-Salmi, Joaquin Sastre, Ioanna Tsiligianni, Arunas Valiulis, Arzu Yorgancioglu, Mihaela Zidarn, Torsten Zuberbier, Joao A. Fonseca, Jean Bousquet

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Background: In clinical and epidemiological studies, cutoffs of patient-reported outcome measures can be used to classify patients into groups of statistical and clinical relevance. However, visual analog scale (VAS) cutoffs in MASK-air have not been tested. Objective: To calculate cutoffs for VAS global, nasal, ocular, and asthma symptoms. Methods: In a cross-sectional study design of all MASK-air participants, we compared (1) approaches based on the percentiles (tertiles or quartiles) of VAS distributions and (2) data-driven approaches based on clusters of data from 2 comparators (VAS work and VAS sleep). We then performed sensitivity analyses for individual countries and for VAS levels corresponding to full allergy control. Finally, we tested the different approaches using MASK-air real-world cross-sectional and longitudinal data to assess the most relevant cutoffs. Results: We assessed 395,223 days from 23,201 MASK-air users with self-reported allergic rhinitis. The percentile-oriented approach resulted in lower cutoff values than the data-driven approach. We obtained consistent results in the data-driven approach. Following the latter, the proposed cutoff differentiating “controlled” and “partly-controlled” patients was similar to the cutoff value that had been arbitrarily used (20/100). However, a lower cutoff was obtained to differentiate between “partly-controlled” and “uncontrolled” patients (35 vs the arbitrarily-used value of 50/100). Conclusions: Using a data-driven approach, we were able to define cutoff values for MASK-air VASs on allergy and asthma symptoms. This may allow for a better classification of patients with rhinitis and asthma according to different levels of control, supporting improved disease management.

Original languageEnglish
Pages (from-to)1281-1289.e5
Number of pages14
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number4
Publication statusPublished - 1 Apr 2023
Externally publishedYes


  • Asthma
  • Conjunctivitis
  • Cutoffs
  • MASK-air
  • Rhinitis


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