Dept of Paediatrics, Amphia Hospital, Breda, The Netherlands.
Eur Respir J. 2011 Sep;38(3):561-6. doi: 10.1183/09031936.00173710. Epub 2011 Mar 15.
Several tools are useful in detecting uncontrolled asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting uncontrolled asthma in children. 145 children with asthma filled in a web-based daily diary card for 4 weeks on symptoms, use of rescue medication and limitations of activities, followed by either the C-ACT or ACT. For predicting uncontrolled asthma, score cut-off points of 19 were used for C-ACT and ACT. According to GINA guidelines, asthma was uncontrolled in 71 (51%) children and completely controlled in 19 (14%) children. The area under the curve in the receiver operating characteristic curves for C-ACT and ACT versus GINA guidelines were 0.89 and 0.92, respectively. Cut-off points of 19 for C-ACT and ACT resulted in a sensitivity of 33% and 66% in predicting uncontrolled asthma, respectively. C-ACT and ACT correlate well with GINA criteria in predicting uncontrolled asthma, but commonly used cut-off points for C-ACT and ACT seem to underestimate the proportion of children with uncontrolled asthma as defined by GINA.
有几种工具可用于检测儿童的未控制哮喘。本研究旨在比较全球哮喘倡议（GINA）指南与儿童哮喘控制测试（C-ACT）和哮喘控制测试（ACT）在检测儿童未控制哮喘方面的效果。145 名哮喘患儿在四周内通过网络在线日记卡填写症状、使用急救药物和活动受限情况，然后填写 C-ACT 或 ACT。对于预测未控制哮喘，C-ACT 和 ACT 的临界值分别为 19。根据 GINA 指南，71 名（51%）患儿哮喘未控制，19 名（14%）患儿哮喘完全控制。C-ACT 和 ACT 与 GINA 指南的受试者工作特征曲线下面积分别为 0.89 和 0.92。C-ACT 和 ACT 的临界值为 19，预测未控制哮喘的敏感性分别为 33%和 66%。C-ACT 和 ACT 与 GINA 标准在预测未控制哮喘方面相关性良好，但 C-ACT 和 ACT 的常用临界值似乎低估了 GINA 定义的未控制哮喘患儿的比例。
