BACKGROUND: Currently, the cornerstone of asthma management is the achievement and maintenance of optimal asthma control, but the diagnostic performances of the Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ) have not been evaluated systematically. OBJECTIVE: We explored the diagnostic performances of and statistically compared the ACT and ACQ. METHODS: Studies that examined the accuracy of the ACT, ACQ, or both in the assessment of asthma control were found by searching PubMed, CENTRAL, Web of Science, Ovid, and Embase. Summary estimates of sensitivity, specificity, and diagnostic odds ratios for the different levels of asthma control were determined by using bivariate random-effects models and hierarchical summary receiver operating characteristic models. RESULTS: Twenty-one studies with 11,141 subjects assessed with the ACT and 12,483 assessed with the ACQ were identified. The ACT had good diagnostic accuracy for assessment of controlled and not well-controlled asthma, and the ACQ (ACQ-7 and ACQ-6) had good diagnostic accuracy for assessment of not well-controlled asthma at prespecified cutoff points. The ACT and ACQ had significant differences in the assessment of controlled and not well-controlled asthma after adjusting for potential factors (P = .001 and P = .015). For assessment of uncontrolled asthma, the ACT had poor accuracy, with a hierarchical summary receiver operating characteristic area under the curve of 0.69, and the cutoff point for the ACQ has not been established. CONCLUSION: The ACT is preferable to the ACQ in clinical practice, and the ACQ requires further cross-validation. Moreover, neither the ACT nor the ACQ is useful for the assessment of uncontrolled asthma.
BACKGROUND: Currently, the cornerstone of asthma management is the achievement and maintenance of optimal asthma control, but the diagnostic performances of the Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ) have not been evaluated systematically. OBJECTIVE: We explored the diagnostic performances of and statistically compared the ACT and ACQ. METHODS: Studies that examined the accuracy of the ACT, ACQ, or both in the assessment of asthma control were found by searching PubMed, CENTRAL, Web of Science, Ovid, and Embase. Summary estimates of sensitivity, specificity, and diagnostic odds ratios for the different levels of asthma control were determined by using bivariate random-effects models and hierarchical summary receiver operating characteristic models. RESULTS: Twenty-one studies with 11,141 subjects assessed with the ACT and 12,483 assessed with the ACQ were identified. The ACT had good diagnostic accuracy for assessment of controlled and not well-controlled asthma, and the ACQ (ACQ-7 and ACQ-6) had good diagnostic accuracy for assessment of not well-controlled asthma at prespecified cutoff points. The ACT and ACQ had significant differences in the assessment of controlled and not well-controlled asthma after adjusting for potential factors (P = .001 and P = .015). For assessment of uncontrolled asthma, the ACT had poor accuracy, with a hierarchical summary receiver operating characteristic area under the curve of 0.69, and the cutoff point for the ACQ has not been established. CONCLUSION: The ACT is preferable to the ACQ in clinical practice, and the ACQ requires further cross-validation. Moreover, neither the ACT nor the ACQ is useful for the assessment of uncontrolled asthma.
Authors: Shelley Dua; Monica Ruiz-Garcia; Simon Bond; Stephen R Durham; Ian Kimber; Clare Mills; Graham Roberts; Isabel Skypala; James Wason; Pamela Ewan; Robert Boyle; Andrew Clark Journal: J Allergy Clin Immunol Date: 2019-07-15 Impact factor: 10.793
Authors: Flory L Nkoy; Bryan L Stone; Bernhard A Fassl; Derek A Uchida; Karmella Koopmeiners; Sarah Halbern; Eun H Kim; Allison Wilcox; Jian Ying; Tom H Greene; David M Mosen; Michael N Schatz; Christopher G Maloney Journal: Pediatrics Date: 2013-11-11 Impact factor: 7.124
Authors: Christine L M Joseph; Mei Lu; Stephanie Stokes-Bruzzelli; Dayna A Johnson; Elizabeth Duffy; Michele Demers; Talan Zhang; Dennis R Ownby; Edward Zoratti; Prashant Mahajan Journal: Ann Allergy Asthma Immunol Date: 2015-11-17 Impact factor: 6.347
Authors: Sonia Cajigal; Karen E Wells; Edward L Peterson; Brian K Ahmedani; James J Yang; Rajesh Kumar; Esteban G Burchard; L Keoki Williams Journal: J Allergy Clin Immunol Pract Date: 2016-08-17