Disagreement among common measures of asthma control in children.

Abstract:

BACKGROUND:Asthma is a worldwide problem. It cannot be prevented or cured, but it is possible, at least in principle, to control asthma with modern management. Control usually is assessed by history of symptoms, physical examination, and measurement of lung function. A practical problem is that these measures of control may not be in agreement. The aim of this study was to describe agreement among different measures of asthma control in children. METHODS:A prospective sequential sample of children aged 4 to 11 years with atopic asthma attending a routine follow-up evaluation were studied. Patients were assessed with the following four steps: (1) fraction of exhaled nitric oxide (FENO), (2) spirometry, (3) Childhood Asthma Control Test (cACT), and (4) conventional clinical assessment by a pediatrician. The outcome for each test was coded as controlled or uncontrolled asthma. Agreement among measures was examined by cross-tabulation and κ statistics. RESULTS:Eighty children were enrolled, and nine were excluded. Mean FENO in pediatrician-judged uncontrolled asthma was double that of controlled asthma (37 parts per billion vs 15 parts per billion, P < .005). There was disagreement among measures of control. Spirometric indices revealed some correlation, but of the unrelated comparisons, those that agreed with each other most often (69%) were clinical assessment by the pediatrician and the cACT. Worst agreement was noted for FENO and cACT (49.3%). CONCLUSION:Overall, different measures to assess control of asthma showed a lack of agreement for all comparisons in this study.

journal_name

Chest

journal_title

Chest

authors

Green RJ,Klein M,Becker P,Halkas A,Lewis H,Kitchin O,Moodley T,Masekela R

doi

10.1378/chest.12-1070

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

117-122

issue

1

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(13)60020-3

journal_volume

143

pub_type

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