Measurement characteristics of the childhood Asthma-Control Test and a shortened, child-only version.

Christian Bime,Joe K Gerald,Janet T Holbrook,Robert A Wise,William G Teague,Christine Y Wei,Lynn B Gerald

doi:10.1038/npjpcrm.2016.75

Abstract

The childhood Asthma-Control Test (C-ACT) is validated for assessing asthma control in paediatric asthma. Among children aged 4–11 years, the C-ACT requires the simultaneous presence of both parent and child. There is an unmet need for a tool that can be used to assess asthma control in children when parents or caregivers are not present such as in the school setting. We assessed the psychometric properties and estimated the minimally important difference (MID) of the C-ACT and a modified version, comprising only the child responses (C-ACTc). Asthma patients aged 6–11 years (n=161) from a previously completed multicenter randomised trial were included. Demographic information, spirometry and questionnaire scores were obtained at baseline and during follow-up. Participants or their guardians kept a daily asthma diary. Internal consistency reliabilities of the C-ACT and C-ACTc were 0.76 and 0.67 (Cronbach’s α), respectively. Test–retest reliabilities of the C-ACT and C-ACTc were 0.72 and 0.66 (intra-class correlation), respectively. Significant correlations were noted between C-ACT scores and ACQ scores (Spearman’s correlation r=−0.56, 95% CI (−0.66, −0.44), P<0.001). The strength of the correlation between C-ACTc scores and ACQ scores was weaker (Spearman’s correlation r=−0.46, 95% CI (−0.58, −0.33), P<0.001). We estimated the MID for the C-ACT and C-ACTc to be 2 points and 1 point, respectively. Among asthma patients aged 6–11 years, the C-ACT had good psychometric properties. The psychometric properties of a shortened child-only version (C-ACTc), although acceptable, are not as strong.

Highlights

One of the main goals of asthma therapy is to achieve and maintain good asthma control.[1]
We examined the psychometric properties of the child responses (C-ACTc) and the full childhood Asthma Control Test (C-ACT), among paediatric patients enrolled in a multicenter clinical trial addressing the use of Lansoprazole in children with poor asthma control and without symptomatic gastroesophageal reflux (GER; NCT00442013).[13]
We showed that among asthma patients aged 6–11 years, the C-ACT has good psychometric properties and a shortened version with only the responses of the child, the C-ACTc is promising but needs additional study before it can be used in scientific research and daily practice

Summary

Introduction

One of the main goals of asthma therapy is to achieve and maintain good asthma control.[1]. Asthma Outcomes Workshop is the childhood Asthma Control Test (C-ACT).[3] The C-ACT is well validated for use among children aged 4–11 years.[4] It is comprised of 3 parent-reported and 4 child-reported items and requires the simultaneous presence of both parent and child. There are no validated alternatives to assess asthma control in children of 4–11 years of age in the absence of the parent or caregiver. Asthma diaries could serve as an alternative, especially if administered as a web-based diary.[11,12] use of asthma diaries among younger patients in the absence of parents has not been demonstrated

Methods

Results

Discussion

Conclusion