Asthma diagnosis and treatmentDevelopment and cross-sectional validation of the Childhood Asthma Control Test
Section snippets
Development of the working questionnaire
The initial conceptual framework of domains for “asthma control” was developed from the national NAEPP1 guidelines, the international GINA2 guidelines, and working group input (10 childhood asthma and allergy specialists). To support this framework and determine further concepts, the literature was reviewed for existing generic and asthma-specific questionnaires as well as relevant literature for developing age-appropriate questions for younger children with asthma.13, 19, 20, 21, 22, 23, 24, 25
Results
The sample characteristics of the children (n = 343) are presented in Table I. The mean age was 8.1 years; 61% were male; and 74.34% were in “good to very good” health based on parent/caregiver report. Approximately 63% of caregivers had a college or graduate degree and about 63% were employed either part or full time. Specialists characterized 62% of the participants with mild, 36% with moderate, and 2% with severe asthma. Specialists concluded that 70.5% of their patients had asthma that was
Discussion
The cross-sectional validation of the C-ACT demonstrates the reliability and predictive properties of the tool to assess asthma control in children 4-11 years of age. The tool shows good ROC characteristics relative to the specialists' ratings of asthma control, as well as good performance of C-ACT scores in their ability to discriminate based on various levels of clinical variables, including spirometry and specialist's recommendation of a change in therapy. In addition, correlation of the
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Disclosure of potential conflict of interest: A. H. Liu has consulting arrangements with GlaxoSmithKline, AstraZeneca, and Schering-Plough; has received grant support from GlaxoSmithKline, Microlife, Ross, and Novartis; and is on the speakers' bureau for GlaxoSmithKline, Merck, Schering-Plough, and AstraZeneca. R. Zeiger has consulting arrangements with Aerocrine, AstraZeneca, Dynavax, Genentech, GlaxoSmithKline, Merck, and Novartis; has received grant support from AstraZeneca, GlaxoSmithKline, Merck, Sanofi-Aventis, and Teva Pharmaceuticals; and has lectured for AstraZeneca. C. Sorkness has consulting arrangements with AstraZeneca and GlaxoSmithKline; has received grant support from GlaxoSmithKline; and is on the speakers' bureaus for GlaxoSmithKline. T. Mahr has received grant support from GlaxoSmithKline, Alcon, AstraZeneca, and Novartis and is on the speakers' bureau for Alcon, AstraZeneca, GlaxoSmithKline, Merck, Schering-Plough, Novartis, Genentech, Verus, and Sanofi-Aventis. N. Ostrom has received grant support from Alcon, Allux, Altana, AstraZeneca, Clay-Park Labs, Critical Therapeutics, Genentech, GlaxoSmithKline, Hoffman-LaRoche, Medicinova, MedPointe, Merck, Novartis, Pharmaxis, Rigel, Sanofi-Aventis, Schering-Plough, and Wyeth; has consulting arrangements with Aperon Biosystems, AstraZeneca, Genentech, and Verus Pharmaceuticals; and is on the speakers' bureau for AstraZeneca, Genentech, Novartis, GlaxoSmithKline, IVAX, KOS, Pfizer, Sanofi-Aventis, and Schering-Plough. S. Burgess has received grant support from GlaxoSmithKline. J. C. Rosenzweig and R. Manjunath are employed by GlaxoSmithKline.