Development and validation of a questionnaire to measure asthma control

Abstract

International guidelines on asthma management indicate that the primary goal of treatment should be optimum asthma control. The aim of this study was to develop and validate the Asthma Control Questionnaire (ACQ).The authors generated a list of all symptoms used to assess control and sent it to 100 asthma clinicians who were members of guidelines committees (18 countries). They scored each symptom for its importance in evaluating asthma control. From the 91 responses, the five highest scoring symptoms were selected for the ACQ. In addition, there is one question on b 2 -agonist use and another on airway calibre (total questions=7). The ACQ was tested in a 9-week observational study of 50 adults with symptomatic asthma. The ACQ and other measures of asthma health status were assessed at baseline, 1, 5 and 9 weeks.In patients whose asthma was stable between clinic visits, reliability of the ACQ was high (intraclass correlation coefficient (ICC)=0.90). The questionnaire was very responsive to change in asthma control (p<0.0001). Cross-sectional and longitudinal validity were supported by correlations between the ACQ and other measures of asthma health status being close to a priori predictions.In conclusion, the Asthma Control Questionnaire has strong evaluative and discriminative properties and can be used with confidence to measure asthma control. Eur Respir J 1999; 14: 902±907. International guidelines indicate that the primary goal of asthma treatment is to achieve optimum control (minimization of day and night time symptoms, bronchoconstriction and short-acting b-agonist use) and thus reduce the risk of life-threatening exacerbations and long-term morbidity [1±4]. COCKCROFT and SWYSTUN [5] have pointed out that asthma "control" concerns the adequacy of treatment, whilst "severity" concerns the underlying disease process: "the common perception that well-controlled asthma is synonymous with mild asthma and that poorly controlled asthma is synonymous with severe asthma is erroneous".A number of questionnaires are described as measuring "asthma severity". In some, the term "severity" has been used appropriately [6,7] and the instruments validated against other measures of airway pathology. No questionnaires have been specifically developed and validated to measure asthma control. Without such an instrument, a simple, quantified method for identifying patients at risk and for evaluating the effects of treatment has been lacking.The authors developed the Asthma Control Questionnaire (ACQ) using recognized procedures for questionnaire specification, item selection and scaling [8] and the authors have examined the measurement properties necessary for its use in clinical practice, clinical trials and cross-sectional surveys [9]. The aim was to develop a simple questionnaire that could be completed in the clinic without daily recordings of symptoms, medication use and airway calibre.

Targeting pCO2 in Asthma: Pilot Evaluation of a Capnometry-Assisted Breathing Training

“…Patients were asked to rate how effective their current medication was (rating 1-4, "always", "most of the times", PCO2 Biofeedback in Asthma 9 "sometimes", or "never"). At the beginning of each therapy session they filled out a questionnaire on frequency of asthma symptoms and how much distress they had caused ("symptom bother scale") (Steen, Hutchinson, McColl, et al, 1994), and self-report items of the Asthma Control Questionnaire (Juniper, O'Byrne, Guyatt, et al, 1999) for the period of the previous week. At the 1 st and 5 th session and at follow-up the Health Survey Short Form-12 (Ware, Kosinski, & Keller, 1996) was also administered.…”

A qualitative analysis of a dyad approach to health-related quality of life measurement in children with asthma

“…The PAQLQ, developed by Juniper and colleagues (Juniper et al, 1996;Juniper, Guyatt, Feeny, Griffith, & Ferrie, 1997;Juniper, O'Byrne, Guyatt, Ferrie, & King, 1999) is a disease-specific HRQOL instrument for children with asthma that has been widely used in clinical trials. The PedsQL ™ Core and Asthma Modules developed by Dr. James W. Varni are generic and disease-specific health status instruments, respectively that measure HRQOL in children with documented reliability and validity (Chan, Mangione-Smith, Burwinkle, Rosen, & Varni, 2005;Varni, Burwinkle, Rapoff, Kamps, & Olson, 2004;Varni, Seid, Knight, Uzark, & Szer, 2002;Varni, Seid, & Kurtin, 2001).…”

Development and validation of a questionnaire to assess asthma control in pediatrics

“…[5][6][7] One of the requirements of these guidelines is the need to assess the level of asthma control. Questionnaires such as the ''Asthma Control Questionnaire'' (ACQ) 8 and the ''Asthma Control Test'' (ACT) 9 have been developed to evaluate the perception of disease control from the patient's point of view in adult populations. However, there are no questionnaires available to measure perceptions of control in pediatric asthma populations, either from the child or the carer's point of view.…”