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Measuring asthma control. Clinic questionnaire or daily diary?
E F Juniper1, P M O'Byrne, P J Ferrie
1Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University Faculty of Health Sciences, Hamilton, London, United Kingdom.
American Journal of Respiratory and Critical Care Medicine
|October 13, 2000
Summary
The Asthma Control Questionnaire and Asthma Control Diary both effectively measure asthma control. However, the clinic-completed questionnaire demonstrated superior reliability and responsiveness compared to the daily diary.
Area of Science:
- Pulmonary Medicine
- Clinical Trials
- Asthma Management
Background:
- Daily symptom and peak expiratory flow rate (PEFR) diaries are commonly used in asthma clinical trials.
- These methods are assumed to offer a more accurate assessment of clinical status than clinic-based questionnaires.
Purpose of the Study:
- To compare the measurement properties of the clinic-completed Asthma Control Questionnaire (ACQ) and the Asthma Control Diary (ACD).
- To evaluate the reliability and responsiveness of both instruments in assessing asthma control.
Main Methods:
- An observational study involving 50 adults with symptomatic asthma.
- Patients completed the ACQ and other asthma status measures at a clinic over 9 weeks.
- Patients also completed the ACD daily for one week prior to each clinic visit.
Main Results:
- High concordance was observed between the ACQ and ACD (ICC = 0.87).
- The ACQ showed better reliability (ICC = 0.90) and responsiveness (responsiveness index = 1.06) than the ACD (reliability ICC = 0.86; responsiveness index = 0.90).
- Correlations with other clinical asthma measures were similar for both instruments.
Conclusions:
- Both the ACQ and ACD are valid tools for measuring asthma control.
- The ACQ exhibits slightly superior discriminative and evaluative measurement properties compared to the ACD.