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Validation of the maximum symptom day among children with asthma

Published:October 18, 2018DOI:https://doi.org/10.1016/j.jaci.2018.10.008
      The maximum symptom day (MSD) is a composite measure of asthma symptomatology that integrates 3 questions related to daytime and nighttime asthma symptoms. It is the largest value of the number of days in the previous 2 weeks that a participant reports (1) cough, wheezing, or shortness of breath, (2) slowed activities due to these symptoms, or (3) nocturnal awakening due to these symptoms. Originally defined in the pivotal National Cooperative Inner City Asthma Study, the MSD has been used as a primary end point in numerous studies of inner-city asthma (some of which are mentioned in the “Studies Using the MSD” section in this article's Online Repository at www.jacionline.org). Surprisingly, since the first publication citing this outcome almost 20 years ago, it has never been validated.
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