The minimal clinically important difference in the Asthma Impairment and Risk Questionnaire

Asthma care specialists consider 2 domains when assessing a patient's clinical status: control, which reflects interference with daily activities and symptom management, and risk, which reflects the likelihood of future adverse outcomes, including asthma exacerbations.1 Although guidelines endorse assessing these 2 domains, natural fluctuations in asthma symptoms make these assessments challenging for patients and clinicians alike, considering that asthma control at a single clinical encounter does not reliably predict risk of future exacerbations. Furthermore, clinicians and patients alike overestimate control owing to anchoring biases and concerns about additional adverse effects from step-up therapy, among other reasons.2 Several instruments have been developed to improve and standardize clinical assessments. Clinicians frequently use the Asthma Control Questionnaire and Asthma Control Test (ACT),3,4 which are 2 validated questionnaires with established cutoffs that signify levels of asthma control and minimal clinically important differences (MCIDs), which represent the smallest changes in survey scores that correspond to important clinical outcomes. The Asthma Impairment and Risk Questionnaire (AIRQ) is a validated instrument that predicts risk of future asthma exacerbations with 10 "yes/no" dichotomous questions, 7 of which address asthma control, and 3 address risk.5