Measuring asthma control: a comparison of three classification systems

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 (G...

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Vydané v:The European respiratory journal Ročník 36; číslo 2; s. 269
Hlavní autori: O'Byrne, P M, Reddel, H K, Eriksson, G, Ostlund, O, Peterson, S, Sears, M R, Jenkins, C, Humbert, M, Buhl, R, Harrison, T W, Quirce, S, Bateman, E D
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England 01.08.2010
Predmet:
Adolescent
Adult
Aged
Aged, 80 and over
Algorithms
Asthma - classification
Asthma - diagnosis
Budesonide - pharmacology
Child
Double-Blind Method
Ethanolamines - pharmacology
Female
Formoterol Fumarate
Humans
Male
Middle Aged
Pulmonary Medicine - methods
Pulmonary Medicine - standards
Retrospective Studies
Surveys and Questionnaires
Time Factors
ISSN:1399-3003, 1399-3003
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Shrnutí: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 (n = 8,188) 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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ISSN:1399-3003
1399-3003
DOI:10.1183/09031936.00124009