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Accuracy of childhood asthma control test among Thai childhood asthma patients
Sirasuda Sommanus1, Chalerat Direkwattanachai2, Saranath Lawpoolsri3
1Department of Pediatrics, Taksin Hospital, Bangkok, Thailand.
Insights
The Thai version of the Childhood Asthma Control Test (C-ACT) accurately assesses asthma control in children. This validated tool, comparable to GINA guidelines, aids in managing pediatric asthma effectively.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Clinical Assessment Tools
Background:
- The Childhood Asthma Control Test (C-ACT) is a global tool for assessing pediatric asthma control.
- A Thai-translated, self-administered version was utilized for this study.
Purpose of the Study:
- To validate the C-ACT cut-points for assessing asthma control levels in Thai children.
- To compare the C-ACT's efficacy against the Global Initiative for Asthma (GINA) guidelines.
Main Methods:
- Validated the Thai C-ACT against GINA guidelines in 279 children with asthma over one year.
- Utilized Receiver Operating Characteristic (ROC) curves and calculated validity indicators (sensitivity, specificity, PPV, NPV) at various cut-points.
Main Results:
- C-ACT scores significantly correlated with FEV1 at 3, 6, and 12 months (p<0.001).
- Area Under the Curve (AUC) exceeded 80% compared to GINA scores across all visits.
- Optimal cut-points identified: ≥23 for controlled asthma and ≤18 for uncontrolled asthma.
Conclusions:
- The Thai C-ACT is a simple, accurate, and effective tool for assessing asthma control in Thai children.
- The Thai C-ACT demonstrates high accuracy, comparable to GINA guidelines, for predicting asthma control levels.
Background:
The Childhood Asthma Control Test (C-ACT) was developed to assess asthma control in children worldwide. A self-administered questionnaire for children translated into Thai language was used.
Objective:
To validate the C-ACT cut-points for evaluating the level of asthma control among Thai children, using the Global Initiative for Asthma (GINA) guideline as a gold standard.
Methods:
C-ACT score, FEV1 and assessment of level of asthma control were recorded at baseline, 3-month, 6-month, and 1-year visits among children with asthma. Receiver operating characteristic (ROC) curves was used to determine the area under the curve (AUC) of C-ACT score for determining the level of asthma control. Validity indicators were calculated at different C-ACT cut-points to determine those most appropriate for predicting controlled and uncontrolled asthma.
Results:
We enrolled 279 children, 64% males, with mean age 6.87±2.4 years. C-ACT score was significantly correlated with FEV1 at 3-month, 6-month, and 1-year visits (p<0.001). The AUC of C-ACT score compared with GINA score were above 80% at all visits. The suggested C-ACT score cut-point of controlled asthma was ≥ 23 (sensitivity 69.5%, specificity 73.3%, positive predictive value (PPV) 81.2%, negative predictive value (NPV) 63.8%); that of uncontrolled asthma was ≤ 18 (sensitivity 54.2%, specificity 96.9%, PPV 61.9%, NPV 95.7%).
Conclusions:
The Thai version of the C-ACT is an accurate, simple, and useful tool for assessing asthma control among Thai children. The high AUC suggests that the Thai C-ACT is as good as the GINA guideline in predicting asthma control level.
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