Liu Andrew H, Zeiger Robert, Sorkness Christine, Mahr Todd, Ostrom Nancy, Burgess Somali, Rosenzweig Jacqueline Carranza, Manjunath Ranjani
National Jewish Medical and Research Center and the University of Colorado School of Medicine, Denver, CO 80206, USA.
J Allergy Clin Immunol. 2007 Apr;119(4):817-25. doi: 10.1016/j.jaci.2006.12.662. Epub 2007 Mar 13.
For children younger than 12 years old with asthma, there are several quality-of-life instruments, clinical diaries, and questionnaires assessing symptoms; however, a validated tool for assessing asthma control is currently lacking.
To develop and validate the Childhood Asthma Control Test (C-ACT), a self-administered tool for identifying children aged 4-11 years whose asthma is inadequately controlled.
A 21-item questionnaire was administered to 343 patients with asthma and their caregivers, randomly assigning 75% (n = 257) for development and cross-sectional validation of the tool and 25% (n = 86) to a confirmatory sample. Stepwise logistic regression was used to reduce the 21 items to those best able to discriminate control as defined by the specialist's rating of asthma control.
Seven items were selected from regression analyses of the development sample to comprise the C-ACT. The scores of each item were summed for a total score (0-27), with lower scores indicating poorer control. Summed scores discriminated between groups of patients differing in the specialists' rating of asthma control (F = 36.89; P < .0001), the need for change in patients' therapy (F = 20.07; P < .0001), and % predicted FEV(1) (F = 2.66; P = .0494). A score of 19 indicated inadequately controlled asthma (specificity 74%, sensitivity 68%). These analyses were confirmed in the confirmatory sample.
The C-ACT is a validated tool to assess asthma control and identify children with inadequately controlled asthma.
The C-ACT can be valuable in clinical practice and research based on its validation, ease of use, input from the child and caregiver, and alignment with asthma guidelines.
对于12岁以下的哮喘儿童，有多种生活质量评估工具、临床日记和症状调查问卷；然而，目前缺乏一种经过验证的评估哮喘控制情况的工具。
开发并验证儿童哮喘控制测试（C-ACT），这是一种用于识别4至11岁哮喘控制不佳儿童的自我评估工具。
向343例哮喘患者及其护理人员发放一份包含21个条目的问卷，随机将75%（n = 257）用于该工具的开发和横断面验证，25%（n = 86）用于验证样本。采用逐步逻辑回归分析，从21个条目中筛选出最能区分由专家评定的哮喘控制情况的条目。
从开发样本的回归分析中选出7个条目组成C-ACT。每个条目的得分相加得到总分（0 - 27分），得分越低表明控制越差。总分能够区分专家评定的哮喘控制情况不同的患者组（F = 36.89；P <.0001）、患者治疗方案改变的必要性（F = 20.07；P <.0001）以及预计第1秒用力呼气容积百分比（F = 2.66；P =.0494）。得分为19分表明哮喘控制不佳（特异性74%，敏感性6）。这些分析在验证样本中得到证实。
C-ACT是一种经过验证的评估哮喘控制情况和识别哮喘控制不佳儿童的工具。
基于其有效性、易用性、儿童和护理人员的反馈以及与哮喘指南的一致性，C-ACT在临床实践和研究中可能具有重要价值。
