Assessment of control of bronchial asthma in children using Childhood Asthma Control Test.

ABSTRACT

Background. The use of Childhood Asthma Control Test (C-ACT) has been advised for monitoring asthma control by the Global Initiative for Asthma (GINA) guidelines. Objective. To validate the tool C-ACT for the assessment of control of asthma and to examine the correlation between C-ACT score and lung function assessed by forced expiratory volume in one second (FEV1). Methods. This was a prospective observational study conducted between January 2010 to January 2011. Children diagnosed to have bronchial asthma and aged 5 to 14 years, were enrolled in the study. Asthma severity and control status were classified according to the National Asthma Education and Prevention Programme (NAEPP) and GINA guidelines, respectively. Patients were followed-up at three and six months and C-ACT and spirometric measurements were obtained. Results. Significant positive correlations were found between C-ACT score and FEV1 at enrollment (r=0.772) (p<0.001), three months (r=0.815) (p<0.001) and at six months follow-up (r=0.908) (p<0.001). Baseline C-ACT score was useful for predicting the levels of control of asthma upto three months (0.004), but not at six months follow-up (0.787). A cut-off C-ACT value of >19 had a sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) 98.5%, 89.1%, 94.9%, 96.6%, 0.717, respectively for the control of asthma. Conclusion. C-ACT is a simple and feasible tool to assess and predict the levels of control in children with bronchial asthma upto three months.