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Asthma Control Test.

Nathalie duRivage1, Michelle Ross2, Stephanie L Mayne1

  • 11 The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Clinical Pediatrics
|November 1, 2016
PubMed
Summary
This summary is machine-generated.

The parent proxy-Asthma Control Test (PP-ACT) effectively identifies most uncontrolled asthma cases in children aged 6-12. While generally reliable, consider its limitations compared to the child-reported C-ACT.

Keywords:
Asthma Control Testasthmaparent proxy reporting

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Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Clinical Trial Methodology

Background:

  • Accurate asthma control assessment is crucial for effective pediatric management.
  • Child-reported outcomes are standard, but parent proxy-reports offer an alternative when direct reporting is challenging.
  • The Childhood-Asthma Control Test (C-ACT) is a validated tool for assessing asthma control in children.

Purpose of the Study:

  • To compare the performance of a parent proxy-version of the Asthma Control Test (PP-ACT) against the validated Childhood-Asthma Control Test (C-ACT).
  • To evaluate the sensitivity, specificity, and concordance of the PP-ACT in identifying uncontrolled asthma in children aged 6 to 12 years.
  • To determine the feasibility and limitations of using parent proxy-reports for asthma control assessment.

Main Methods:

  • A randomized controlled trial involving 104 parent-child dyads with children aged 6-12 years with asthma.
  • Participants were randomized to complete either the PP-ACT followed by C-ACT, or C-ACT followed by PP-ACT.
  • Statistical analyses included calculation of sensitivity, specificity, positive predictive value, negative predictive value, and concordance (Kappa statistic).

Main Results:

  • The PP-ACT demonstrated 86% sensitivity and 88% negative predictive value for detecting uncontrolled asthma (scores ≤19).
  • Over 75% of surveys showed concordance between PP-ACT and C-ACT, with moderate agreement (κ = 0.54).
  • The PP-ACT identified most children with uncontrolled asthma, with few cases missed.

Conclusions:

  • The parent proxy-Asthma Control Test (PP-ACT) is a valuable tool for assessing pediatric asthma control, particularly when child self-reporting is not feasible.
  • While the PP-ACT shows good performance and concordance with the C-ACT, clinicians should be aware of potential limitations inherent in proxy reporting.
  • Further consideration of proxy reporting's role in asthma management is warranted to optimize survey receipt and data accuracy.