Spencer Sally, Mayer Bhabita, Bendall Kate L, Bateman Eric D
Brunel University, Uxbridge, UK.
Respir Res. 2007 Mar 21;8(1):26. doi: 10.1186/1465-9921-8-26.
A global definition of asthma control does not currently exist. The purpose of this study was to validate two new guideline-based composite measures of asthma control, defined as totally controlled (TC) asthma and well controlled (WC) asthma.
We used data from 3416 patients randomised and treated in the multi-centre Gaining Optimal Asthma controL (GOAL) study. The criteria comprising the asthma control measures were based on Global Initiative for Asthma/National Institutes of Health guidelines. This validation study examined the measurement properties of the asthma control measures using data from run-in, baseline, 12 and 52 weeks. Forced expiratory volume in 1 second (FEV1) and the Asthma Quality of Life Questionnaire (AQLQ) were used as the reference criteria in the validation analysis.
Both measures had good discriminative ability showing significant differences in FEV1 and AQLQ scores between control classification both cross-sectionally and longitudinally (p < 0.001). Overall both of the composite measures accounted for more of the variance in FEV1 after 52 weeks than the individual components of each asthma control measure. Both of the reference criteria were independently related to each asthma control measure (p < 0.0001). The measures also had good predictive validity showing significant differences in FEV1 and AQLQ scores at 52 weeks by control classification at 12 weeks (p < 0.0001).
The guideline-based composite asthma control measures of WC asthma and TC asthma have good psychometric properties and are both valid functional indices of disease control in asthma.
目前尚无哮喘控制的全球定义。本研究的目的是验证两种基于新指南的哮喘控制综合指标，即完全控制（TC）哮喘和良好控制（WC）哮喘。
我们使用了多中心“获得最佳哮喘控制”（GOAL）研究中3416例随机分组并接受治疗的患者的数据。构成哮喘控制指标的标准基于全球哮喘防治创议/美国国立卫生研究院的指南。这项验证研究使用了导入期、基线期、12周和52周的数据来检验哮喘控制指标的测量特性。在验证分析中，使用一秒用力呼气容积（FEV1）和哮喘生活质量问卷（AQLQ）作为参考标准。
两种指标均具有良好的鉴别能力，在横断面和纵向上，不同控制分类之间的FEV1和AQLQ评分均显示出显著差异（p < 0.001）。总体而言，52周后，两种综合指标对FEV1变异的解释比每种哮喘控制指标的各个组成部分都更多。两种参考标准均与每种哮喘控制指标独立相关（p < 0.0001）。这些指标还具有良好的预测效度，12周时的控制分类在52周时的FEV1和AQLQ评分上显示出显著差异（p < 0.0001）。
基于指南的WC哮喘和TC哮喘综合哮喘控制指标具有良好的心理测量特性，均是哮喘疾病控制的有效功能指标。
