A psychometric comparison of three patient-based measures of asthma control

Wallenstein, Gene V.; Carranza-Rosenzweig, Jacqueline; Kosinski, Mark; Blaisdell-Gross, Bonnie; Gajria, Kavita; Jhingran, Priti

doi:10.1185/030079906x167426

Cited by 32 publications

(23 citation statements)

References 14 publications

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“…The area under the ROC curve (AUC) was acceptable at 0.85 (95% CI 0.80 to 0.88) and of similar magnitude to previous findings for the ACT. 7,14,[17][18][19][20] The ACT has been shown to be a reliable tool by previous authors, 7,8,[14][15][16][17]21,22 and this is confirmed by this study in a Vietnamese outpatient setting in which Cronbach's alpha reached 0.83, indicating a high consistency among the answers to the five questions.…”

Section: -9supporting

confidence: 74%

The Asthma Control Test (ACT) as an alternative tool to Global Initiative for Asthma (GINA) guideline criteria for assessing asthma control in Vietnamese outpatients

Nguyen

Chavannes

et al. 2011

Primary Care Respiratory Journal

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Aims: To determine the reliability and validity of the Asthma Control Test (ACT) to detect Global Initiative for Asthma (GINA)-defined uncontrolled or partly controlled asthma, and to determine the agreement between ACT and GINA in classifying asthma control among Vietnamese patients. Methods:A cross-sectional study was performed in 323 of 360 invited outpatients with asthma in Ho Chi Minh City to compare the ACT and GINA classification for asthma control.Results: Internal consistency of the ACT (Cronbach's alpha) was 0.83. The kappa coefficient of 0.55, based on the ternary split, represents moderate agreement between the two rating systems with a correctly classified rate of 75%. The area under the receiver operating characteristics curve for the ACT score predicting GINA control was 0.85. To detect GINA-defined 'not controlled asthma', the ACT had a sensitivity of 70%, specificity of 93%, and a positive predictive value of 89%, with a cut-off point of 19. The validity of the ACT with regard to agreement with the GINA classification was consistent across both sexes, but less so in adolescents or younger adults. The ACT score was significantly correlated with the percentage predicted forced expiratory volume in 1 second (r=0.35, p<0.001) and percentage predicted peak expiratory flow (r=0.26, p<0.001). Conclusions:The Vietnamese ACT is useful for identifying outpatients with GINA-defined uncontrolled or partly controlled asthma.

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Section: -9supporting

confidence: 74%

The Asthma Control Test (ACT) as an alternative tool to Global Initiative for Asthma (GINA) guideline criteria for assessing asthma control in Vietnamese outpatients

Nguyen

Chavannes

et al. 2011

Primary Care Respiratory Journal

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“…The area under the ROC curve, the single measure incorporating the most information on the relationship between ACT predicting GINA, was quite adequate at 0.84 and of a similar magnitude to prior findings for the ACT as well as other case identification instruments for asthma, allergy, and chronic obstructive pulmonary disease. [28][29][30] An ACT score >20 predicted GINA-defined controlled asthma 51% of the time, and the kappa statistic (0.42) suggested a moderate agreement using the cut-off point of >20 for 'well controlled' asthma. This is largely because substantial numbers of patients with an ACT score >20 had GINA 'partly controlled', and a few GINA 'uncontrolled', asthma.…”

Section: Discussionmentioning

confidence: 99%

The Asthma Control TestTM (ACT) as a predictor of GINA guideline-defined asthma control: analysis of a multinational cross-sectional survey

Thomas

Kay

Pike

et al. 2009

Primary Care Respiratory Journal

271

207

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Aims: To evaluate whether the Asthma Control Test TM (ACT) score is predictive of Global Initiative for Asthma (GINA) guideline-defined classification levels of asthma control. The ACT is a validated, 5-item, patient-completed measure of asthma control with a recall period of four weeks.Methods: Cross-sectional survey comparing ACT score and GINA classification of asthma control among 2949 patients attending primary care physicians and specialists in France, Germany, Italy, Spain, the UK, and the USA. Results:The area under the receiver operating characteristics curve for ACT score predicting GINA control was 0.84 (95% CI 0.82-0.85). An ACT score of <19 (not well-controlled asthma) correctly predicted GINA-defined partly controlled/uncontrolled asthma 94% of the time, while an ACT score of >20 predicted GINA-defined controlled asthma 51% of the time, with kappa statistic of 0.42, representing moderate agreement.Conclusions: An ACT score <19 is useful for identifying patients with poorly controlled asthma as defined by GINA.

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“…However, the working definition of the GINA criteria differed from that used in the present analysis as, in the earlier analysis, exacerbations experienced during the previous 12 months were included in the assessment of partly controlled asthma; exclusion of this criterion substantially improved the positive predictive value of an ACT score of o20. The ACT and ACQ have also been compared in a smaller population of patients, [20] and the authors concluded that these two measurement tools had comparable reliability, validity, accuracy and responsiveness.…”

Section: Discussionmentioning

confidence: 99%

Measuring asthma control: a comparison of three classification systems

O'Byrne¹,

Reddel²,

Eriksson³

et al. 2010

Eur Respir J

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There are various ways to classify asthma control; however, no classification is universally accepted. This retrospective analysis compared asthma control as assessed by the Asthma Control Questionnaire (5-item version; ACQ-5), Global Initiative for Asthma (GINA) or Gaining Optimal Asthma Control (GOAL) study criteria.Pooled data at the final study week (n58,188) from three budesonide/formoterol maintenance and reliever therapy studies which measured ACQ-5 were stratified according to GINA or GOAL criteria and ACQ-5 score distribution. The percentages of patients with a controlled/partly controlled week (GINA), totally/well-controlled week (GOAL) and range of ACQ-5 cut-off points were compared.Patients with GINA controlled, partly controlled and uncontrolled asthma had mean ACQ-5 scores of 0.43, 0.75 and 1.62, respectively. Patients with GOAL totally controlled, well-controlled and uncontrolled asthma had ACQ-5 scores of 0.39, 0.78 and 1.63. The kappa measure of agreement was 0.80 for GINA and GOAL criteria, and 0.63 for GINA controlled/partly controlled and ACQ-5 ,1.00. ACQ-5 detected clinically important improvements in 49% of patients who, according to GINA criteria, remained uncontrolled at the end of the study.Asthma control measured by GINA or GOAL criteria provides similar results. GINA Controlled/ Partly Controlled and GOAL Totally Controlled/Well-Controlled correspond to ACQ-5 ,1.00. The ACQ-5 is more responsive to change in a clinical trial setting than a categorical scale.

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A psychometric comparison of three patient-based measures of asthma control

Cited by 32 publications

References 14 publications

The Asthma Control Test (ACT) as an alternative tool to Global Initiative for Asthma (GINA) guideline criteria for assessing asthma control in Vietnamese outpatients

The Asthma Control Test (ACT) as an alternative tool to Global Initiative for Asthma (GINA) guideline criteria for assessing asthma control in Vietnamese outpatients

The Asthma Control TestTM (ACT) as a predictor of GINA guideline-defined asthma control: analysis of a multinational cross-sectional survey

Measuring asthma control: a comparison of three classification systems

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