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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Pulmonary Medicine 1/2015

Parents and adolescents preferences for asthma control: a best-worst scaling choice experiment using an orthogonal main effects design

BMC Pulmonary Medicine > Ausgabe 1/2015
Wendy J. Ungar, Anahita Hadioonzadeh, Mehdi Najafzadeh, Nicole W. Tsao, Sharon Dell, Larry D. Lynd
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12890-015-0141-9) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

WJU, LDL and MN conceived and designed the study, AH and SD contributed to study design, WJU supervised data collection, AH collected the study data, NWT and SD contributed to data collection, MN and AH conducted the statistical analysis, WJU and NWT contributed to the data analysis, all authors contributed to the interpretation of the results, and WJU drafted and revised the manuscript. All authors commented on and approved the final manuscript.



The preferences of parents and children with asthma influence their ability to manage a child’s asthma and achieve good control. Potential differences between parents and adolescents with respect to specific parameters of asthma control are not considered in clinical asthma guidelines. The objective was to measure and compare the preferences of parents and adolescents with asthma with regard to asthma control parameters using best worst scaling (BWS).


Fifty-two parents of children with asthma and 44 adolescents with asthma participated in a BWS study to quantify preferences regarding night-time symptoms, wheezing/chest tightening, changes in asthma medications, emergency visits and physical activity limitations. Conditional logit regression was used to determine each group’s utility for each level of each asthma control parameter.


Parents displayed the strongest positive preference for the absence of night-time symptoms (β = 2.09, p < 0.00001) and the strongest negative preference for 10 emergency room visits per year (β = −2.15, p < 0.00001). Adolescents displayed the strongest positive preference for the absence of physical activity limitations (β = 2.17, p < 0.00001) and the strongest negative preference for ten physical activity limitations per month (β = −1.97). Both groups were least concerned with changes to medications.


Parents and adolescents placed different weights on the importance of asthma control parameters and each group displayed unique preferences. Understanding the relative importance placed on each parameter by parents and adolescents is essential for designing effective patient-focused disease management plans.
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