Related Experiment Video
Updated: May 1, 2026
Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber
Published on: March 3, 2023
Asthma control assessment in a pediatric population: comparison between GINA/NAEPP guidelines, Childhood Asthma
A Deschildre1, I Pin, K El Abd
1Unité de pneumologie-allergologie pédiatrique, pôle enfant, clinique de pédiatrie Jeanne de Flandre, CHRU de Lille, Université Nord de France, Lille, France.
Insights
Asthma control assessment in children shows discrepancies between various tools, with age and exacerbations impacting results. The Childhood Asthma Control Test (C-ACT) cutoff needs refinement for better clinical correlation.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Asthma Management
Background:
- Asthma control requires regular assessment using validated tools like the Childhood Asthma Control Test (C-ACT).
- Current guidelines include GINA2006 and NAEPP for asthma control evaluation.
Purpose of the Study:
- To compare asthma control assessments using GINA2006, NAEPP, pediatrician's assessment (PA), and C-ACT in pediatric patients.
- To identify discrepancies in asthma control evaluation methods in children.
Main Methods:
- Collected demographic data, treatment, and exacerbation history from 525 asthmatic children.
- Assessed asthma control via GINA 2006 (strict and modified), NAEPP criteria, PA, and parent/child C-ACT completion.
Main Results:
- Significant discrepancies were found between assessment methods, with 76.5% uncontrolled by GINA 2006 vs. 34% by PA.
- Lower C-ACT scores correlated with younger age (≤ 6 years) and severe exacerbations.
- Pediatrician's assessment showed strong correlation with C-ACT scores (e.g., C-ACT > 21 indicated control in 89% of cases).
Conclusions:
- Discrepancies exist in asthma control assessment tools for children, influenced by age and exacerbation history.
- The C-ACT cutoff of 19 requires re-evaluation for optimal performance against pediatrician's assessment.
- Comprehensive asthma control assessment should integrate symptoms, lung function, and long-term exacerbation data.
Background:
Guidelines recommend regular assessment of asthma control. The Childhood Asthma Control Test (C-ACT) is a clinically validated tool.
Aim:
To evaluate asthma control according to GINA2006, NAEPP, pediatrician's assessment (PA), and C-ACT in asthmatic children visiting their ambulatory pediatrician or tertiary care pediatric pulmonologist.
Methods:
Demographic data, treatment, and number of severe exacerbations during the previous year were collected. Control was assessed using (i) strict GINA 2006 criteria, (ii) GINA without taking into account the exacerbation item, (iii) NAEPP criteria, and (iv) PA. Children and parents filled out the C-ACT.
Results:
Five hundred and twenty-five children completed the survey (mean age: 7.7 years; 28% ≤ 6 years). 78% had a controller treatment. 58% reported ≥ 1 severe exacerbation. C-ACT was ≤ 19 in 29.5%. Control was not achieved in 76.5%, 55%, 40%, and 34% according to GINA 2006 guidelines, NAEPP guidelines, GINA 2006 without exacerbation criteria, and PA, respectively. C-ACT was significantly lower in children ≤ 6 years old (P = 0.002) or with severe exacerbations (P < 0.0001). According to PA, 89% of patients with a C-ACT > 21 were controlled and 85% of patients with a C-ACT < 17 not controlled.
Conclusion:
We observed discrepancies between the different tools applied to assess asthma control in children, and the impact of age and exacerbations. Cutoff point of 19 of C-ACT was not associated with the best performance compared to PA. Assessment of control should take into account symptoms and lung function as suggested by the latest GINA guidelines as well as exacerbation over a long period.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:30Asthma-IV: Nursing Management
First, in...
01:13Asthma III: Clinical Manifestations
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:28Asthma I: Introduction