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

Abstract

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). 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. 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 ± 3.6 SD vs. 25.4 ± 1.8 SD; P < 0.000), 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. M, VAS^children, and FeNO. 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. Pediatr Pulmonol. 2012; 47:113–118.