Avaliação do questionário de controle da asma validado para uso no Brasil

Abstract

Objective: To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ) is a valid instrument to measure asthma control in adult outpatients in Brazil. Methods: We selected 278 outpatients diagnosed with asthma. All of the patients completed the questionnaire, underwent spirometry and were clinically evaluated by a physician in order to characterize the control of the disease in the first visit. The questionnaire was evaluated in three versions, with 5, 6 and 7 questions, respectively, and scores of 0.75 and 1.50 were used as cut-off points. Results: Of the 278 patients, 77 (27.7%) had intermittent asthma, 39 (14.0%) had mild persistent asthma, 40 (14.4%) had moderate persistent asthma and 122 (43.9%) had severe persistent asthma. The sensitivity of ACQ to identify uncontrolled asthma ranged from 77% to 99%, and the specificity ranged from 36% to 84%. The positive predictive value ranged from 73% to 90%, and the negative predictive value ranged from 67% to 95%. The positive likelihood ratio ranged from 1.55 to 4.81, and the negative likelihood ratio ranged from 0.03 to 0.27. In the 5-and 6-question versions of the ACQ, the intraclass correlation coefficient was 0.92. These two versions were both responsive to clinical changes in the patients. Conclusions: All three versions of the ACQ satisfactorily discriminated between patients with uncontrolled asthma and those with controlled asthma. The 5-and 6-question versions also presented good reliability and responsiveness. Therefore, the ACQ is a valid tool for evaluating asthma control in adult outpatients in Brazil.Keywords: Asthma; Therapeutics; Diagnosis; Questionnaires; Reproducibility of results. ResumoObjetivo: Avaliar se a versão em língua portuguesa do Asthma Control Questionnaire (ACQ, Questionário de Controle da Asma) é um instrumento válido para medir o controle da asma em pacientes adultos ambulatoriais no Brasil. Métodos: Foram avaliados 278 pacientes ambulatoriais com diagnóstico de asma. Todos os pacientes, durante a primeira visita, responderam ao questionário, foram submetidos à espirometria e avaliados clinicamente por um médico para a caracterização do controle da doença. Foram analisadas as versões do questionário com 5, 6 e 7 questões, utilizando dois escores distintos (0,75 e 1,50) como pontos de corte. Resultados: Dos 278 pacientes, 77 (27,7%) tinham asma intermitente, 39 (14,0%) asma persistente leve, 40 (14,4%) asma persistente moderada e 122 (43,9%) asma persistente grave. A sensibilidade do questionário para identificar asma não-controlada variou de 77% a 99% e a especificidade variou de 36% a 84%. O valor preditivo positivo variou de 73% a 90%, e o valor preditivo negativo variou de 67% a 95%. A razão de verossimilhança positiva variou de 1,55 a 4,81, e a razão de verossimilhança negativa variou de 0,03 a 0,27. Nas versões do ACQ com 5 e 6 questões, o coeficiente de correlação intraclasse foi de 0,92, e estas versões foram responsivas a mudanças no quadro clínico dos pacientes. Conclusões: O ACQ, nas suas t...

Comparação entre dois métodos de avaliação do controle da asma baseados na percepção individual

“…(22) Individuals with poor perception of asthma control might be at increased risk of severe exacerbations, given that they fail to detect worsening in time to institute preventive treatment, (23) as well as constituting a group at increased risk of developing respiratory failure. (24) In 2008, Leite et al (10) calculated the sensitivity and specificity of the ACQ-6 relative to the evaluation by a specialist. Using an ACQ-6 score of 1.5 as a cut-off point, those authors found a sensitivity of 77%, a specificity of 84%, a positive predictive value of 0.9, and a negative predictive value of 0.67 in the identification of uncontrolled asthma.…”

“…Scores ≥ and < 1.5, respectively, indicate uncontrolled asthma and controlled asthma. In that study, (10) there was a comparison between the ACQ scores and the evaluation of asthma control by a pulmonologist, which was used as the gold standard for classifying asthma control, including information regarding pulmonary function. It was concluded that the questionnaire was a good identifier of uncontrolled asthma, which is a major concern in clinical practice.…”

“…(9) The ACQ measures adequacy of asthma control and change in asthma control, which occurs spontaneously or as a result of treatment. The ACQ has been recently validated for use in Brazil, (10) and has been found to have good accuracy, responsiveness, and reproducibility when administered to patients with severe asthma.…”

Efeito agudo do salbutamol no sistema cardiovascular durante o exercício físico em pacientes com asma moderada ou grave: estudo aleatorizado, duplo-cego e cruzado

“…Prior to the first experimental session, patients were submitted to the Asthma Control Questionnaire (ACQ-7), duly validated 11 to assess the effectiveness of asthma control 12 . Patients were selected to perform 2 distinct experimental sessions on 2 nonconsecutive days.…”

InteliMed: Uma experiência de desenvolvimento de sistema móvel de suporte ao diagnóstico médico

“…Diversos estudos sobre a asma têm sido publicados no Brasil e no exterior contendo normatizações de condutas, que são os guidelines [17,18,19,20,21,22,23,24]. Esses estudos visam à ampla difusão do conhecimento sobre o tema e a uma correta abordagem diagnóstica com vistas ao tratamento adequado.…”