Relationship of the Asthma Control Test (ACT) with Lung Function,Levels of Exhaled Nitric Oxide and Control According to the Global Initiative for Asthma (GINA) |
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| Authors: | Francisco Javier Álvarez-Gutiérrez Juan Francisco Medina-Gallardo Pablo Pérez-Navarro Juan José Martín-Villasclaras Bernardo Martin Etchegoren Beatriz Romero-Romero Juan Manuel Praena-Fernández |
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| Affiliation: | 1. Unidad de Asma CE Fleming, UMQER, Hospital Universitario Virgen del Rocío, Sevilla, Spain;2. Servicio de Neumología, Hospital Carlos Haya, Málaga, Spain;3. Servicio de Neumología, Hospital San Cecilio, Granada, Spain;4. Servicio de Neumología, Hospital San Juan de Dios, Bormujos, Sevilla, Spain;5. Unidad de Metodología y Evaluación de Investigación, Fundación Pública Andaluza para la Gestión de la Investigación en Salud, HU, Virgen del Rocío, Sevilla, Spain;1. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas;2. Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas;1. Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas;2. Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas;1. Department of Biostatistics, Brown University, Providence, RI, USA;2. Department of Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 49100, Israel;3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;1. Department of Pediatrics, Taipei City Hospital, Renai Branch, Taiwan;2. Colleges of Medicine, National Yang-Ming University, Taipei, Taiwan;3. Department of Pediatrics, Taipei City Hospital, Yangming Branch, Taiwan;1. Department of Medicine, Queen''s University, Kingston, ON, Canada;2. Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada;3. Institute for Clinical Evaluative Sciences, Queen''s University and University of Toronto, Toronto, ON, Canada;4. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada |
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| Abstract: | IntroductionThe current goal of asthma treatment is to achieve and maintain control. This study aimed to explore the relationship between the ACT (Asthma Control Test) questionnaire and the levels of control according to GINA (Global Initiative for Asthma) to establish the cut-off points for the ACT and evaluate its relationship with lung function and fractionated exhaled nitric oxide level (FeNO).Patients and methodsA multi-centre prospective study including 441 patients followed up in an outpatient Chest Clinic. A clinical protocol was followed, and FeNO, spirometry and ACT performed. Disease was classified according to levels of control using GINA. The study analysed sensitivity, specificity and area under the curve (ROC), and the ACT cut-off points. We studied the differences between the functional parameters and FeNO between levels of control.ResultsFor controlled asthma the cut-off obtained was ACT≥ 21 (area under the curve 0.791) and for uncontrolled ≤ 18 (AUC 0.774). We found significant differences in FeNO levels and pulmonary function among ACT≥ 21 and ACT ≤ 18, although only 26.3% of patients with ACT≤ 18 had a FEV1 <80% and 40% higher FeNO (≥ 35 ppb). We found a correlation between baseline FEV1 and ACT (r = 0.19, P < 0.01) and between ACT and FeNO (r = -0.16, P < 0.01).ConclusionsThe cut-off points would be, for controlled asthma ACT≥ 21, partly controlled asthma ACT = 19-20 and uncontrolled asthma ACT ≤ 18. A more complete assessment would require including monitoring operating parameters and FeNO. |
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