Nonetheless, considerable differences between them still exist. For instance, they use different ranges for their scoring systems. Whereas the ACQ is scored using a 7-point scale, from 0 totally controlled to 6 extremely poorly controlled , the ACT total score ranges from 5 poor control of asthma to 25 complete control of asthma. The targeted patient age is another difference among tools. Despite the reported merits of these tools, they are not without shortcomings.
This finding limits the ability to use these tools interchangeably. Also, a review by Halbert et al 10 highlighted the discrepancy between the content of most of the tools and the national and international guidelines. Nevertheless, the LASS was the only tool reviewed above that evaluated the risk of asthma exacerbations as part of its assessment. Furthermore, the ACQ is the only tool included in the above review that comprises lung function as part of the asthma control measure.
Despite the fact that measures of lung function are infrequently performed because spirometry equipment is costly and is not always available, 79 these measures are considered an essential criterion of asthma control in both the GINA and NAEPP EPR-3 guidelines.
Knowledge of the psychometric properties of asthma control assessment tools is critical to ensure that the tool selected will measure the desired outcome.
Among the tools reviewed, the ACQ has been used in the majority of clinical trials, and the ACT has the most published validation data. Both tools have been validated for use as self-administered tools in person, at home, 40 or by telephone 26 and in different languages.
For instance, in the United States, studies have included mostly white patients. Furthermore, the modes and settings in which those tools can be administered vary as well ie, in-person, at home, over the telephone, in various clinical settings, or over the internet. Thus, clinicians not only need to review the results of the psychometric properties of tools, but they need to also consider whether the tool was evaluated with a similar population and in a similar setting as their intended use.
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We do not capture any email address. Skip to main content. Review Article Review. Yahya A Alzahrani. Abstract Both the National Asthma Education and Prevention Program Expert Panel Report 3 and the Global Initiative for Asthma guidelines identify achieving and maintaining asthma control as goals of therapy, and they emphasize periodic assessment of asthma control once treatment is established. Introduction Asthma continues to be a common disease associated with high mortality and high economic and social tolls despite the advances in the understanding of the pathophysiology of asthma, the availability of effective preventive therapy, and the availability of international treatment guidelines.
Asthma Control Test The ACT is a multidimensional, standardized, and validated tool and the most widely used tool for assessing asthma control in patients with asthma older than 12 y. Reliability Nathan et al 9 reported high internal consistency of the ACT score with specialists' ratings among subjects with controlled asthma as well as subjects with uncontrolled asthma 0.
Responsiveness Schatz et al 13 reported that changes in ACT scores were strongly correlated with changes in ACQ scores, moderately correlated with changes in specialist control ratings, and weakly correlated with change in percent-of-predicted FEV 1 values. Responsiveness Changes in the cACT scores correlated well with changes in specialists' ratings of asthma control but correlated poorly with changes in peak expiratory flow rate.
Asthma Control Questionnaire The ACQ is another multidimensional, standardized, patient-centered test and is the most widely used asthma control assessment tool in clinical trials. Reliability The ACQ has shown high reliability in adult subjects who remained clinically stable between consecutive visits to the clinic an intraclass correlation coefficient of 0.
Asthma Therapy Assessment Questionnaire The ATAQ is a brief, self-administered tool, developed to identify individuals 18 y and older with possible asthma control problems. Accuracy An ATAQ score of 1 or greater was used as an established cutoff value for uncontrolled versus controlled asthma.
Validity Lara et al 73 assessed the construct validity of the children's version of the LASS score in a sample of Latino parents of children with asthma. Accuracy Although the design of the LASS specifies that a higher score indicates more symptoms, the cutoff values that distinguish between patients' different levels of asthma control have not been established.
Responsiveness In the developmental study, 73 the responsiveness of the LASS was assessed by measuring the changes in the total scores related to the changes in the health status. Summary To facilitate an accurate and objective assessment of asthma control, tools that are multidimensional, simple, and relatively short and easy to administer have been developed. View this table: View inline View popup.
Table 1. Characteristics of Asthma Control Assessment Tools. The authors have disclosed no conflicts of interest. Accessed May, 15, Economic burden of asthma: a systematic review. BMC Pulm Med ; 9 : The costs of asthma.
Eur Respir J ; 9 4 : — OpenUrl Abstract. National Asthma Education and Prevention Program. Expert Panel Report 3 EPR-3 : guidelines for the diagnosis and management of asthma-summary report Erratum in: J Allergy Clin Immunol ; 6 Vollmer WM. Assessment of asthma control and severity. Ann Allergy Asthma Immunol ; 93 5 : — A new perspective on concepts of asthma severity and control.
Eur Respir J ; 32 3 : — Evaluation of asthma control by physicians and patients: comparison with current guidelines. Can Respir J ; 9 6 : — OpenUrl PubMed. Revicki D , Weiss K. Clinical assessment of asthma symptom control: review of current assessment instruments.
J Asthma ; 43 7 : — Development of the Asthma Control Test: a survey for assessing asthma control. J Allergy Clin Immunol ; 1 : 59 — Measuring asthma control is the first step to patient management: a literature review. J Asthma ; 46 7 : — Asthma control test and asthma quality of life questionnaire association in adults. Iran J Allergy Asthma Immunol ; 11 4 : — Validation of a standardized version of the asthma quality of life questionnaire.
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Measurements are crucial Holly Tull, BASM, RRT, respiratory care manager at Virginia Mason Memorial Hospital in Yakima, WA, believes respiratory care departments should be looking at everything from ventilator protocols to nebulizer treatments to infection control and should be using value analysis to make decisions on the products and services they bring in to the hospital.
Creating positive change Ken Stanford, RRT, manager of respiratory care at Bassett Medical Center in Cooperstown, NY, says all of his staff members are required to work on a process improvement project throughout the year. Most Popular. Get Newsroom in your mailbox :. This field is for validation purposes and should be left unchanged.
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