Woo Yeon Lee1, Dong In Suh2, Dae Jin Song3, Hey-Sung Baek4, Meeyong Shin5, Young Yoo6, Ji-Won Kwon7, Gwang Cheon Jang8, Hyeon-Jong Yang9, Eun Lee10, Ju-Hee Seo11, Sung-Il Woo12, Hyung Young Kim13, Youn Ho Shin14, Ju Suk Lee15, Jisun Yoon16, Sungsu Jung17, Minkyu Han18, Eunjin Eom19, Jinho Yu17, Woo Kyung Kim20, Dae Hyun Lim21, Jin Tack Kim22, Woo-Sung Chang23, Jeom-Kyu Lee23, Hwan Soo Kim1. 1. Department of Pediatrics, School of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea. 2. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. 3. Department of Pediatrics, Korea University College of Medicine, Seoul, Korea. 4. Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea. 5. Department of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, Korea. 6. Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea. 7. Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea. 8. Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea. 9. Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea. 10. Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. 11. Department of Pediatrics, Dankook University Hospital, Cheonan, Korea. 12. Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea. 13. Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea. 14. Department of Pediatrics, Gangnam CHA Medical Center CHA University School of Medicine, Seoul, Korea. 15. Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. 16. Department of Pediatrics, Mediplex Sejong Hospital, Incheon, Korea. 17. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 18. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea. 19. Department of Statistics, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea. 20. Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea. 21. Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea. 22. Department of Pediatrics, School of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's hospital, Uijeongbu, Korea. 23. Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, Korea.
Abstract
Objective: Various numerical asthma control tools have been developed to distinguish different levels of symptom control. We aimed to examine whether the asthma control test (ACT) is reflective of objective findings such as lung function, fractional exhaled nitric oxide (FeNO) and laboratory data in patients with stable asthma. Methods: We included patients who were enrolled in the Korean Childhood Asthma Study. ACT, spirometry, blood tests and FeNO were performed in patients after stabilization of their asthma. We examined differences among spirometry parameters, blood tests and FeNO according to control status as determined by ACT and investigated for any significant correlations. Results: The study population consisted of 441 subjects. Spirometry showed that forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of forced vital capacity and FEV1/forced vital capacity were all significantly higher in the controlled asthma group. Likewise, FeNO and percent-change in FEV1 were both significantly lower in the controlled asthma group. In blood tests, the eosinophil fraction was significantly lower in the controlled asthma group while white blood cell count was significantly higher in the controlled asthma group. Lastly, among the various factors analyzed, only provocative concentration of methacholine causing a 20% fall in FEV1 significantly correlated with ACT score. Conclusion: ACT is useful as part of the routine evaluation of asthmatic children and should be used as a complement to existing tools such as spirometry and FeNO measurement.
Objective: Various numerical asthma control tools have been developed to distinguish different levels of symptom control. We aimed to examine whether the asthma control test (ACT) is reflective of objective findings such as lung function, fractional exhaled nitric oxide (FeNO) and laboratory data in patients with stable asthma. Methods: We included patients who were enrolled in the Korean Childhood Asthma Study. ACT, spirometry, blood tests and FeNO were performed in patients after stabilization of their asthma. We examined differences among spirometry parameters, blood tests and FeNO according to control status as determined by ACT and investigated for any significant correlations. Results: The study population consisted of 441 subjects. Spirometry showed that forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of forced vital capacity and FEV1/forced vital capacity were all significantly higher in the controlled asthma group. Likewise, FeNO and percent-change in FEV1 were both significantly lower in the controlled asthma group. In blood tests, the eosinophil fraction was significantly lower in the controlled asthma group while white blood cell count was significantly higher in the controlled asthma group. Lastly, among the various factors analyzed, only provocative concentration of methacholine causing a 20% fall in FEV1 significantly correlated with ACT score. Conclusion: ACT is useful as part of the routine evaluation of asthmatic children and should be used as a complement to existing tools such as spirometry and FeNO measurement.