Age and African-American race impact the validity and reliability of the asthma control test in persistent asthmatics

Research - Open Access
Allison J. BurbankKrista TodoricPamela SteeleJonathan RosenHaibo ZhouMarcia FryeCeila E. LoughlinSally IvinsKatherine MillsLauren Dembicki MasseyBryce B. Reeve and Michelle L. Hernandez

Abstract

Background

The Asthma Control Test (ACT) is widely used to assess asthma control, yet the validity and reliability of the test have not been specifically evaluated in adolescents or African-Americans. We conducted a prospective psychometric study of the ACT in African-American (AA) and non-African-American (nAA) adolescents with persistent asthma, with emphasis on the clinical utility of the test for medical decision making.

Methods

Participants completed the ACT and performed spirometry. A physician conducted a guidelines-based assessment of asthma control, blinded to the ACT score. Study procedures were repeated 6–8 weeks later. The ACT-based asthma control assessment was compared to physician assessment.

Results

For baseline and follow-up visits, internal consistency, as measured using Cronbach’s alpha, was 0.80 and 0.81 in AA teens and 0.80 and 0.83 in nAA teens. Intraclass correlation coefficients were 0.59 and 0.76 in AA and nAA teens, respectively, with stable asthma control over time. Agreement between ACT and physician assessment was moderate in AA teens and fair in nAA teens. An ACT score of ≤19 showed reduced sensitivity for not well controlled asthma in both groups, while a score of ≤21 had the greatest area under the ROC curve. ACT scores were marginally responsive to change in control status.

Conclusions

Concerns for the ACT’s ability to detect uncontrolled asthma in adolescents emphasizes the need for a more comprehensive evaluation of asthma control in clinical settings. A higher threshold ACT score to define not well controlled asthma may be needed if the ACT is to be used for medical decision making.

Download PDF

 

 

(You must be logged in to add and reply comments)

Interasma on Twitter

Interasma Top story: Data Sharing Report | Asthma UK https://t.co/LjNWghYL44, see more https://t.co/CpGiFuOOYd
13hreplyretweetfavorite
Interasma RT @AllergyEaaci: Advances in managing COPD related to α1‐antitrypsin deficiency: An under‐recognized genetic disorder. Download Article He…
15hreplyretweetfavorite
Interasma RT @Aller_MD: My Tweeted Times https://t.co/36WLWcQjoy - top stories by @GavinPrestonMD, @CleanAirLondon
15hreplyretweetfavorite
Interasma RT @Aller_MD: NIH, Children's National Health System join forces to study pediatric disease https://t.co/vdbhviWhMF
15hreplyretweetfavorite
Interasma RT @eaaci_patients: AAAAI & EAACI answer your questions on asthma and air quality. Save the date and join the Twitter chat on 27 September…
15hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

Copyright © Interasma 2003-2017  •  Terms of Use  •  Privacy Policy  •  Contact Us  •  Sitemap

Powered by FREI SA

InterAsma