Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT)

Abstract

Several tools are useful in detecting uncontrolled asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting uncontrolled asthma in children.145 children with asthma filled in a web-based daily diary card for 4 weeks on symptoms, use of rescue medication and limitations of activities, followed by either the C-ACT or ACT. For predicting uncontrolled asthma, score cut-off points of 19 were used for C-ACT and ACT.According to GINA guidelines, asthma was uncontrolled in 71 (51%) children and completely controlled in 19 (14%) children. The area under the curve in the receiver operating characteristic curves for C-ACT and ACT versus GINA guidelines were 0.89 and 0.92, respectively. Cut-off points of 19 for C-ACT and ACT resulted in a sensitivity of 33% and 66% in predicting uncontrolled asthma, respectively.C-ACT and ACT correlate well with GINA criteria in predicting uncontrolled asthma, but commonly used cut-off points for C-ACT and ACT seem to underestimate the proportion of children with uncontrolled asthma as defined by GINA.

Association between the Results of the Childhood Asthma Control Test and Objective Parameters in Asthmatic Children

“…A recent study showed that a cutoff score of 12 for the C-ACT can identify children with very poorly controlled asthma (22). Another study comparing C-ACT scores and asthma control levels based on the GINA criteria found that a cutoff score of 19 resulted in a high specificity (100%) but a low sensitivity (33%) for detecting children with uncontrolled asthma (23). Using each cutoff score adequately might help clinicians to optimize asthma therapy.…”

Monitoring asthma in children

“…Although a single numerical value to express asthma control is highly attractive, C-ACT, ACT and ACQ do not include exacerbations and future risks, such as lung function decline [66][67][68][69]. Therefore, these composite scores appear to underestimate the level of asthma control as defined by GINA [70]. Recently, two composite asthma control scores have been developed that include exacerbations: the Test for Respiratory and Asthma Control in Kids (TRACK) and the Composite Asthma Severity Index (CASI) [71,72].…”

Update on the current methods for the diagnosis and treatment of severe childhood asthma

“…Possible treatment options for school aged children with severe asthma The purpose of pediatric asthma treatment for the child is to control symptoms, to be able to lead a normally active life, to have normal lung function and to prevent asthma exacerbations [86,87]. A stepwise therapeutic approach is applied where medications are adjusted depending on symptom and several guidelines have been published to support the physician in these treatment decisions [4, [87][88][89][90][91].…”