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Asthma Control Questionnaire in children: validation, measurement properties, interpretation
E F Juniper1, K Gruffydd-Jones, S Ward
1Dept of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. juniper@qoltech.co.uk
Insights
The Asthma Control Questionnaire (ACQ) is valid and reliable for assessing asthma control in children aged 6-16 years. This tool effectively measures symptom reduction and improves asthma management in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Clinical Assessment Tools
- Asthma Management
Background:
- The Asthma Control Questionnaire (ACQ) is validated for adults.
- Pediatric asthma management requires reliable assessment tools.
- Current tools may not fully capture pediatric asthma control.
Purpose of the Study:
- To evaluate the validity, measurement properties, and interpretability of the ACQ in children aged 6-16 years.
- To establish the ACQ's reliability and responsiveness to changes in asthma control.
- To determine the Minimal Important Difference (MID) for the ACQ in pediatric populations.
Main Methods:
- 35 children (6-16 years) completed ACQ, Mini-PAQLQ, RCP 'Three Questions' at 0, 1, and 4 weeks.
- Parents completed P-AQLQ; children used Asthma Control Diary and PEF measurements.
- Clinicians and parents used Global Rating of Change Questionnaires; test-retest reliability assessed in 19 stable children.
Main Results:
- ACQ demonstrated good test-retest reliability (ICC 0.79) in stable children.
- ACQ was responsive to changes in asthma control (p=0.026) with a mean MID of 0.52 ± 0.45.
- Correlations between ACQ and other outcomes supported its validity for measuring pediatric asthma control.
Conclusions:
- The Asthma Control Questionnaire (ACQ) exhibits strong measurement properties and is valid for children aged 6-16 years.
- The ACQ is a reliable and responsive tool for assessing pediatric asthma control.
- Trained interviewers are recommended for ACQ administration in children aged 6-10 years.
Abstract:
The Asthma Control Questionnaire (ACQ) has been validated in adults to measure the primary goal of management (minimisation of symptoms, activity limitations, short-acting β₂-agonist use and airway narrowing). The present study evaluated the validity, measurement properties and interpretability of the ACQ in children aged 6-16 yrs. 35 children attended clinic on three occasions (0, 1 and 4 weeks) and completed the ACQ, Mini Paediatric Asthma Quality of Life Questionnaire and the Royal College of Physicians' "Three Questions". Parents completed the Paediatric Asthma Caregiver's Quality of Life Questionnaire. Between visits, children completed the Asthma Control Diary and measured peak expiratory flow. At weeks 1 and 4, clinicians and parents completed Global Rating of Change Questionnaires. All patients completed the study. 19 children were stable between two assessments and provided evidence of good test-retest reliability (intraclass correlation coefficient 0.79). The ACQ was responsive to change in asthma control (p = 0.026) and the mean ± sd Minimal Important Difference was 0.52 ± 0.45. Both cross-sectional and longitudinal correlations between the ACQ and the other outcomes were close to predicted and provided evidence that the ACQ measures asthma control in children. The ACQ has strong measurement properties and is valid for use in children aged 6-16 yrs. In children aged 6-10 yrs, it must be administered by a trained interviewer.
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