Department of Pediatrics, Taksin Hospital, Bangkok, Thailand.
Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Asian Pac J Allergy Immunol. 2018 Sep;36(3):152-158. doi: 10.12932/AP-300517-0094.
The Childhood Asthma Control Test (C-ACT) was developed to assess asthma control in children worldwide. A self-administered questionnaire for children translated into Thai language was used.
To validate the C-ACT cut-points for evaluating the level of asthma control among Thai children, using the Global Initiative for Asthma (GINA) guideline as a gold standard.
C-ACT score, FEV1 and assessment of level of asthma control were recorded at baseline, 3-month, 6-month, and 1-year visits among children with asthma. Receiver operating characteristic (ROC) curves was used to determine the area under the curve (AUC) of C-ACT score for determining the level of asthma control. Validity indicators were calculated at different C-ACT cut-points to determine those most appropriate for predicting controlled and uncontrolled asthma.
We enrolled 279 children, 64% males, with mean age 6.87±2.4 years. C-ACT score was significantly correlated with FEV1 at 3-month, 6-month, and 1-year visits (p<0.001). The AUC of C-ACT score compared with GINA score were above 80% at all visits. The suggested C-ACT score cut-point of controlled asthma was ≥ 23 (sensitivity 69.5%, specificity 73.3%, positive predictive value (PPV) 81.2%, negative predictive value (NPV) 63.8%); that of uncontrolled asthma was ≤ 18 (sensitivity 54.2%, specificity 96.9%, PPV 61.9%, NPV 95.7%).
The Thai version of the C-ACT is an accurate, simple, and useful tool for assessing asthma control among Thai children. The high AUC suggests that the Thai C-ACT is as good as the GINA guideline in predicting asthma control level.
儿童哮喘控制测试（C-ACT）是为了评估全球儿童的哮喘控制情况而开发的。使用已翻译成泰语的自我管理问卷。
使用全球哮喘倡议（GINA）指南作为金标准，验证 C-ACT 切点用于评估泰国儿童哮喘控制水平。
在基线、3 个月、6 个月和 1 年访视期间，记录哮喘儿童的 C-ACT 评分、FEV1 和哮喘控制水平评估。使用受试者工作特征（ROC）曲线确定 C-ACT 评分的曲线下面积（AUC），以确定哮喘控制水平。在不同的 C-ACT 切点计算有效性指标，以确定最适合预测控制和未控制哮喘的切点。
我们共纳入 279 名儿童，其中 64%为男性，平均年龄为 6.87±2.4 岁。C-ACT 评分与 3 个月、6 个月和 1 年访视时的 FEV1 显著相关（p<0.001）。C-ACT 评分与 GINA 评分的 AUC 在所有访视中均高于 80%。提示控制哮喘的 C-ACT 评分切点为≥23（敏感性 69.5%，特异性 73.3%，阳性预测值（PPV）81.2%，阴性预测值（NPV）63.8%）；未控制哮喘的切点为≤18（敏感性 54.2%，特异性 96.9%，PPV 61.9%，NPV 95.7%）。
泰国版 C-ACT 是评估泰国儿童哮喘控制情况的准确、简单、有用的工具。高 AUC 表明泰国 C-ACT 与 GINA 指南一样能够预测哮喘控制水平。
