The strategy for predicting future exacerbation of asthma using a combination of the Asthma Control Test and lung...

Various factors have been reported to be useful for predicting future exacerbations.

This study was intended to determine a usefulness of a combination of a patient-based questionnaire, such as the Asthma Control Test (ACT) score with objective assessments, such as forced expiratory volume in 1 second (FEV(1)) and/or exhaled nitric oxide (FE(NO)), for predicting future exacerbations in adult asthmatics.

We therefore enrolled 78 subjects with mild to moderate asthma, who were clinically stable for 3 months who all had been regularly receiving inhaled steroid treatment. All subjects underwent a routine assessment of asthma control including the ACT score, spirometry, and FE(NO), and then were followed up until a severe exacerbation occurred. The predictors of an increased risk of severe exacerbation were identified and validated using decision trees based on a classification and regression tree (CART) analysis. The properties of the developed models were the evaluated with the area under the ROC curve (AUC) (95% confidence interval [CI]).

The CART analysis automatically selected the variables and cut-off points, the ACT score

These results demonstrated that combining the ACT score and percentage of predicted FEV(1), but not FE(NO,) can sufficiently stratify the risk for future exacerbations within one year.