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Identifying 'well-controlled' and 'not well-controlled' asthma using the Asthma Control Questionnaire
Elizabeth F Juniper1, Jean Bousquet, Linda Abetz
1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. juniper@qoltech.co.uk
Respiratory Medicine
|October 18, 2005
Summary
The Asthma Control Questionnaire (ACQ) identifies optimal cut-points for well-controlled asthma at 0.75 and inadequately controlled asthma at 1.50. These values aid clinicians and researchers in asthma management and clinical trials.
Area of Science:
- Pulmonary Medicine
- Clinical Research Methodology
Background:
- The 7-item Asthma Control Questionnaire (ACQ) is validated for assessing asthma management goals per international guidelines.
- Current ACQ scoring ranges from 0 (totally controlled) to 6 (severely uncontrolled).
Purpose of the Study:
- To determine optimal ACQ cut-points for differentiating 'well-controlled' from 'not well-controlled' asthma.
- To establish cut-points suitable for both clinical practice and clinical trial patient selection.
Main Methods:
- Analysis of 1323 patient datasets from the Gaining Optimal Asthma Control (GOAL) clinical trial at week 12.
- Utilized a gold standard for 'well-controlled' asthma based on GINA/NIH guidelines and clinical data.
Main Results:
- The crossover point between controlled and uncontrolled asthma is approximately 1.00 on the ACQ.
- An ACQ score of 0.75 is optimal for confidently identifying well-controlled asthma (NPV=0.85).
- An ACQ score of 1.50 is optimal for confidently identifying inadequately controlled asthma (PPV=0.88).
Conclusions:
- Defined ACQ cut-points of 0.75 and 1.50 enhance clinical practice by aiding treatment decisions.
- These cut-points improve clinical trial enrollment by better identifying poorly controlled patients.
- The findings facilitate accurate evaluation of asthma treatment goal achievement.