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VOLUME 56 , ISSUE 2 ( April-June, 2014 ) > List of Articles

Original Article

Assessment of Control of Bronchial Asthma in Children Using Childhood Asthma Control Test

Shiva Prasad Chalise, Nisha K. Bhatta, Rupa R. Singh, Maya Shankar Prasad, Prakash Poudel

Keywords : Childhood asthma, FEV1, Childhood Asthma Control Test

Citation Information : Chalise SP, Bhatta NK, Singh RR, Prasad MS, Poudel P. Assessment of Control of Bronchial Asthma in Children Using Childhood Asthma Control Test. Indian J Chest Dis Allied Sci 2014; 56 (2):75-78.

DOI: 10.5005/ijcdas-56-2-75

License: CC BY-NC 4.0

Published Online: 28-06-2022

Copyright Statement:  Copyright © 2014; The Author(s).


Background. The use of Childhood Asthma Control Test (C-ACT) has been advised for monitoring asthma control by the Global Initiative for Asthma (GINA) guidelines. Objective. To validate the tool C-ACT for the assessment of control of asthma and to examine the correlation between C-ACT score and lung function assessed by forced expiratory volume in one second (FEV1). Methods. This was a prospective observational study conducted between January 2010 to January 2011. Children diagnosed to have bronchial asthma and aged 5 to 14 years, were enrolled in the study. Asthma severity and control status were classified according to the National Asthma Education and Prevention Programme (NAEPP) and GINA guidelines, respectively. Patients were followed-up at three and six months and C-ACT and spirometric measurements were obtained. Results. Significant positive correlations were found between C-ACT score and FEV1 at enrollment (r=0.772) (p<0.001), three months (r=0.815) (p<0.001) and at six months follow-up (r=0.908) (p<0.001). Baseline C-ACT score was useful for predicting the levels of control of asthma upto three months (0.004), but not at six months follow-up (0.787). A cut-off C-ACT value of > 19 had a sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) 98.5%, 89.1%, 94.9%, 96.6%, 0.717, respectively for the control of asthma. Conclusion. C-ACT is a simple and feasible tool to assess and predict the levels of control in children with bronchial asthma upto three months.

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  1. Masoli M, Fabian D, Holt S, Beasley R. The global burden of asthma: executive summary of the GINA Dissemination Committee Report. Allergy 2004;59:469-78.
  2. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2011. Available at URL:
  3. Liu AH, Zeiger R, Sorkness C, Mahr T, Ostrom N, Burgess S, et al. Development and cross-sectional validation of the Childhood Asthma Control Test. J Allergy Clin Immunol 2007;119:817-25.
  4. Brooks SM, Bernstein IL, Raghuprasad PK, Maccia CA, Mieczkowski L. Assessment of airway hyperresponsiveness in chronic stable asthma. J Allergy Clin Immunol 1990;85:17-26.
  5. Kowal K, Bodzenta-Lukaszyk A, Zukowsk S. Exhaled nitric oxide in evaluation of young adults with chronic cough. J Asthma 2009;46:692-8.
  6. Ehrs PO, Nokela M, Björn Ställberg, Hjemdah Pl, Jonsson EW. Brief questionnaires for patient-reported outcomes in asthma: validation and usefulness in a primary care setting. Chest 2006;129:925-32.
  7. Schatz M, Sorkness CA, Li JT, Marcus P, Murray JJ, Nathan RA, et al. Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol 2006;117:549-56.
  8. Liu AH, Zeiger RS, Sorkness CA, Ostrom NK, Chipps BE, Rosa K, et al. The Childhood Asthma Control Test: retrospective determination and clinical validation of a cut point to identify children with very poorly controlled asthma. J Allergy Clin Immunol 2010;126:267-73.
  9. The National Asthma Education and Prevention Program. Guidelines for the Diagnosis and Management of Asthma. Bethesda: National Institute of Health, National Heart, Lung, and Blood Institute. Expert Panel Report II. 2007.
  10. Zhou X, Ding FM, Lin JT, Yin KS. Validity of asthma control test for asthma control assessment in Chinese primary care settings. Chest 2009;1354:904-10.
  11. Alvarez-Gutiérrez FJ, Medina-Gallardo JF, Pérez-Navarro P, Martín-Villasclaras JJ, Martin Etchegoren B, Romero-Romero B, et al. Comparison of the Asthma Control Test (ACT) with lung function, levels of exhaled nitric oxide and control according to the Global Initiative for Asthma (GINA). Arch Bronconeumol 2010;46:370-7.
  12. Fuhlbrigge AL, Weiss ST, Kuntz KM, Paltiel AD. Forced expiratory volume in 1 second percentage improves the classification of severity among children with asthma. Pediatrics 2006;118:e347.
  13. Fuhlbrigge AL, Kitch BT, Paltiel AD, Kuntz KM, Neumann PJ, Dockery DW, et al. FEV(1) is associated with risk of asthma attacks in a pediatric population. J Allergy Clin Immunol 2001;107:61-67.
  14. Leung TF, Ko FW, Wong GW, Li CY, Yung E, Hui DS, et al. Wong predicting changes in clinical status of young asthmatics: clinical scores or objective parameters? Pediatric Pulmonol 2009;44:442-49.
  15. Kitch BT, Paltiel AD, Kuntz KM, Dockery DW, Schouten JP, Weiss ST, et al. A single measure of FEV1 is associated with risk of asthma attacks in long-term follow-up. Chest 2004;126:1875-82.
  16. Lai CK, Ko FW, Bhome A, DE Guia TS, Wong GW, Zainudin BM, et al. Relationship between asthma control status, the Asthma Control Test™ and urgent health-care utilization in Asia. Respirology 2011;16:688-97.
  17. Schatz M, Kosinski M, Sorkness C. Comparison of two patient based measures of asthma control: ACT and ACQ. Proceedings of American Thoracic Society International Conference. Philadelphia: American Thoracic Society; 2005:A255.
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