Assessing asthma control: Symptom scores, GINA levels of asthma control, lung function, and exhaled nitric oxide

摘要

Background The childhood asthma control test (C-ACT) is a validated symptom score for assessing asthma control in children. We used a slightly modified version (C-ACT M) of the German C-ACT and compared our results with the literature, correlated the children's part of C-ACT (C-ACT children) with a visual analogue scale (VAS children), explored the agreement between C-ACT M and GINA levels of asthma control, as well as the relationship between C-ACT M and lung function and exhaled nitric oxide (FeNO). Methods We investigated 107 children with a diagnosis of asthma. The study protocol consisted of a clinical examination, assessment of asthma control according to GINA guidelines, administration of C-ACT M, VAS children, lung function, and FeNO. Results Of our patients 66% had, according to GINA, partly controlled-/uncontrolled asthma, 18% were uncontrolled according to C-ACT M. Children with partly controlled-/uncontrolled asthma according to GINA had lower C-ACT M scores than did children with controlled asthma (16.1±3.6SD vs. 25.4±1.8 SD; P0.000), and children with a C-ACT M score ≤ 19 had poorer lung function (mean FEV1% predicted 81.5 ± 13.5 SD vs. 94.2±12.1 SD; P=0.002). Spearman's rank correlation coefficients revealed significant correlations between all symptom scores. Multiple linear regression adjusted for age, gender, FEV1 and FeNO demonstrated a significant relationship between C-ACT M, VAS children, and FEV1 (P=0.003, resp. 0.000), but no significant correlation between C-ACT M, VAS children, and FeNO. Conclusions The German version of C-ACT M is valid and useful for monitoring children with asthma along with tests aimed to follow up lung function and airway inflammation. Concordance between C-ACT M and GINA is moderate, because asthma control assessed by C-ACT M allows more symptoms and lung function is not included in the scoring.