Sandra Voorend-van Bergen1, Anja A Vaessen-Verberne2, Anneke M Landstra3, Hein J Brackel4, Norbert J van den Berg5, Daan Caudri1, Johan C de Jongste1, Peter J Merkus6, Mariëlle W Pijnenburg7. 1. Department of Pediatric Pulmonology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands. 2. Department of Pediatrics, Amphia Hospital, Breda, The Netherlands. 3. Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands. 4. Department of Pediatrics, Catharina Hospital, Eindhoven, The Netherlands. 5. Department of Pediatrics, Flevo Hospital - De Kinderkliniek, Almere, The Netherlands. 6. Department of Pediatric Pulmonology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. 7. Department of Pediatric Pulmonology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: m.pijnenburg@erasmusmc.nl.
Abstract
BACKGROUND: Data from asthma diaries are frequently used as an end point in asthma studies; however, data on the validity of Web-based diaries are scarce. OBJECTIVES: First, we examined the validity of a Web-based diary in assessing asthma control. Second, we determined the cutoff points for well-controlled asthma of the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT), and calculated the minimal important difference for both tests. METHODS: Children with asthma, ages 4-18 years (n = 228) completed a 4-week Web-based diary, C-ACT, ACT, and an asthma-related quality-of-life questionnaire at baseline and after 1-year follow-up. RESULTS: The completion rate of the Web-based diaries was 89%. The diary scores correlated strongly with C-ACT and ACT scores (r = -0.73, P < .01; r = -0.64, P < .01, respectively) and the changes in diary scores correlated well with changes in C-ACT and ACT scores. The best cutoff points for well-controlled asthma were C-ACT ≥ 22 and ACT ≥ 23. The minimal important differences were 1.9 (95% CI, 1.3-2.5) for ACT and 1.6 (95% CI, 1.1-2.1) for C-ACT, and -0.7 points/d (95% CI, -1.1 to -0.4) for the Web-based diary. CONCLUSIONS: Our Web-based diary was valid for recording asthma symptoms. Cutoff points of ≥22 (C-ACT) and ≥23 (ACT) define well-controlled asthma. We recommend a 2 C-ACT and ACT points difference as minimally important.
BACKGROUND: Data from asthma diaries are frequently used as an end point in asthma studies; however, data on the validity of Web-based diaries are scarce. OBJECTIVES: First, we examined the validity of a Web-based diary in assessing asthma control. Second, we determined the cutoff points for well-controlled asthma of the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT), and calculated the minimal important difference for both tests. METHODS:Children with asthma, ages 4-18 years (n = 228) completed a 4-week Web-based diary, C-ACT, ACT, and an asthma-related quality-of-life questionnaire at baseline and after 1-year follow-up. RESULTS: The completion rate of the Web-based diaries was 89%. The diary scores correlated strongly with C-ACT and ACT scores (r = -0.73, P < .01; r = -0.64, P < .01, respectively) and the changes in diary scores correlated well with changes in C-ACT and ACT scores. The best cutoff points for well-controlled asthma were C-ACT ≥ 22 and ACT ≥ 23. The minimal important differences were 1.9 (95% CI, 1.3-2.5) for ACT and 1.6 (95% CI, 1.1-2.1) for C-ACT, and -0.7 points/d (95% CI, -1.1 to -0.4) for the Web-based diary. CONCLUSIONS: Our Web-based diary was valid for recording asthma symptoms. Cutoff points of ≥22 (C-ACT) and ≥23 (ACT) define well-controlled asthma. We recommend a 2 C-ACT and ACT points difference as minimally important.
Keywords:
Asthma; GINA; Internet diaries; asthma diaries; asthma-related quality of life; childhood asthma control test; minimal important difference; pediatrics; validity
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