Back
 Health  Vol.8 No.7 , May 2016
Correlation between the Childhood-Asthma Control Test and the Criterion for Clinical Asthma Control
Abstract: Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled; patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.
Cite this paper: Ortiz-Lizcano, C. , Niederbacher-Velásquez, J. and Díaz-Martínez, L. (2016) Correlation between the Childhood-Asthma Control Test and the Criterion for Clinical Asthma Control. Health, 8, 623-629. doi: 10.4236/health.2016.87065.
References

[1]   Araújo, L. (2006) Natural History of Asthma. In: Reys, M.A., Aristizabal, G. and Leal, F., Ed., Pediatric Pulmonology. Infection, Allergy, and Respiratory Disease in Children, Panamericana, Bogotá, 482-486.

[2]   Dennis, R.J., Caraballo, L., Garcia, E., Rojas, M.X., Rondon, M.A., Perez, A., et al. (2012) Prevalence of Asthma and Other Allergic Conditions in Colombia 2009-2010: A Cross-Sectional Study. BMC Pulmonary Medicine, 12, 17.
http://dx.doi.org/10.1186/1471-2466-12-17

[3]   Zitt, M.J. (2007) Advances in Inhaled Corticosteroid Pharmacology. Allergy and Asthma Proceedings, 28, 114-124.
http://dx.doi.org/10.2500/aap.2007.28.2989

[4]   (2007) Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. Journal of Allergy and Clinical Immunology, 120, S94-S138.
http://dx.doi.org/10.1016/j.jaci.2007.09.029

[5]   Muino, A., Torello, T.P. and Brea, S. (2010) Test Control Asthma in Children: Childhood ACT. Clinical Utility and Daily Practice. Archivos de Pediatria del Uruguay, 81, 78-86.

[6]   Nathan, R.A., Sorkness, C.A., Kosinski, M., Schatz, M., Li, J.T., Marcus, P., et al. (2004) Development of the Asthma Control Test: A Survey for Assessing Asthma Control. Journal of Allergy and Clinical Immunology, 113, 59-65.
http://dx.doi.org/10.1016/j.jaci.2003.09.008

[7]   Vega, J.M., Badia, X., Badiola, C., Lopez-Vina, A., Olaguibel, J.M., Picado, C., et al. (2007) Validation of the Spanish Version of the Asthma Control Test (ACT). Journal of Asthma, 44, 867-872.
http://dx.doi.org/10.1080/02770900701752615

[8]   Boulet, L.P., Boulet, V. and Milot, J. (2002) How Should We Quantify Asthma Control? A Proposal. Chest, 122, 2217- 2223. http://dx.doi.org/10.1378/chest.122.6.2217

[9]   Rodrigo, G.J., Arcos, J.P., Nannini, L.J., Neffen, H., Broin, M.G., Contrera, M., et al. (2008) Reliability and Factor Analysis of the Spanish Version of the Asthma Control Test. Annals of Allergy, Asthma & Immunology, 100, 17-22.
http://dx.doi.org/10.1016/S1081-1206(10)60399-7

[10]   Liu, A.H., Zeiger, R., Sorkness, C., Mahr, T., Ostrom, N., Burgess, S., et al. (2007) Development and Cross-Sectional Validation of the Childhood Asthma Control Test. Journal of Allergy and Clinical Immunology, 119, 817-825.
http://dx.doi.org/10.1016/j.jaci.2006.12.662

[11]   Liu, A.H., Zeiger, R.S., Sorkness, C.A., Ostrom, N.K., Chipps, B.E., Rosa, K., et al. (2010) The Childhood Asthma Control Test: Retrospective Determination and Clinical Validation of a Cut Point to Identify Children with Very Poorly Controlled Asthma. Journal of Allergy and Clinical Immunology, 126, 267-273, 273.e1.

[12]   Global Strategy for Asthma Management and Prevention, Revised 2006.
www.ginaasthma.org/Guidelineitem

[13]   Wenzel, S.E. (2006) Asthma: Defining of the Persistent Adult Phenotypes. The Lancet, 368, 804-813.
http://dx.doi.org/10.1016/S0140-6736(06)69290-8

[14]   Cronbach, L.J. (1951) Coefficient Alpha and the Internal Structure of Tests. Psychometrika, 16, 297-334.
http://dx.doi.org/10.1007/BF02310555

[15]   Cohen, J. (1960) A Coefficient of Agreement for Nominal Scales. Educational and Psychological Measurement, 20, 37-46. http://dx.doi.org/10.1177/001316446002000104

[16]   Diamond, G.A. (1986) Reverend Bayes’ Silent Majority. An Alternative Factor Affecting Sensitivity and Specificity of Exercise Electrocardiography. American Journal of Cardiology, 57, 1175-1180.
http://dx.doi.org/10.1016/0002-9149(86)90694-6

[17]   Pepe, M.S. (2003) The Statistical Evaluation of Medical Tests for Classification and Prediction. Oxford University Press, New York.

[18]   Brandao, H.V., Cruz, C.S., Guimaraes, A., Camargos, P.A. and Cruz, á.A. (2010) Predictors of Hospital Admission Due to Asthma in Children and Adolescents Enrolled in an Asthma Control Program. Jornal Brasileiro de Pneumologia, 36, 700-706.

[19]   Piacentini, G.L., et.al. (2009) Childhood Asthma Control Test and Airway Inflammation Evaluation in Asthmatic Children. Allergy, 64, 1753-1757.
http://dx.doi.org/10.1111/j.1398-9995.2009.02068.x

[20]   Rodríguez-Martínez, C.E., Melo-Rojas, A., Restrepo-Gualteros, S.M., Sossa-Briceno, M.P. and Nino, G. (2014) Validation of the Spanish Version of the Childhood Asthma Control Test (cACT) in a Population of Hispanic Children. Journal of Asthma, 51, 855-862.
http://dx.doi.org/10.3109/02770903.2014.921197

[21]   Jat, K.R. (2013) Spirometry in Children. Primary Care Respiratory Journal, 22, 221-229.
http://dx.doi.org/10.4104/pcrj.2013.00042

[22]   Gaffin, J.M., Shotola, N.L., Martin, T.R. and Phipatanakul, W. (2010) Clinically Useful Spirometry in Preschool-Aged Children: Evaluation of the 2007 American Thoracic Society Guidelines. Journal of Asthma, 47, 762-767.
http://dx.doi.org/10.3109/02770903.2010.485664

 
 
Top