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Identifying uncontrolled asthma in young children: clinical scores or objective variables?

T F Leung1, F W S Ko, H Y Sy

  • 1Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. tfleung@cuhk.edu.hk

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|March 3, 2009
PubMed

Insights

The Childhood Asthma Control Test (C-ACT) effectively identifies uncontrolled asthma in young children. This validated tool, alongside disease severity scores, aids in assessing asthma control in pediatric patients.

Area of Science:

  • Pediatric Pulmonology
  • Asthma Management
  • Clinical Assessment Tools

Background:

  • International asthma guidelines stress the need for asthma control assessment.
  • Limited data exists on the utility of current tools for assessing asthma control in young children.
  • This study addresses the gap by evaluating assessment tools in pediatric asthma patients.

Purpose of the Study:

  • To investigate the effectiveness of the Chinese version of the Childhood Asthma Control Test (C-ACT) in identifying uncontrolled asthma (UA) in young children.
  • To compare the C-ACT with other disease-related factors in assessing asthma control.
  • To evaluate the diagnostic performance of C-ACT and other parameters for UA in pediatric asthma.

Main Methods:

  • 113 children aged 4-11 years completed the C-ACT during a clinic visit.
  • Exhaled nitric oxide and spirometry (FEV(1)) were measured.
  • Investigator assigned Disease Severity Score (DSS) and rated asthma control per GINA guidelines.

Main Results:

  • 35% of patients had uncontrolled asthma (UA).
  • C-ACT, DSS, FEV(1), and PEF were significantly associated with asthma control status (p < 0.014).
  • C-ACT and DSS demonstrated the highest predictive value for UA (p < 0.001), with a combined sensitivity of 77% and specificity of 84% using CART analysis.

Conclusions:

  • The C-ACT is a valuable tool for identifying uncontrolled asthma in young Chinese children.
  • C-ACT demonstrates superior performance compared to objective measures like spirometry in identifying UA in this population.
  • The findings support the use of C-ACT as a primary assessment tool for pediatric asthma control.
Abstract

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