The Asthma Control Test and Asthma Control Questionnaire for assessing asthma control: Systematic review and meta-analysis - 27/02/13
, Hong Ping Zhang, MD a, , Yan Lv, MD a, , Rui Liang, MD a, Yun Qiu Jiang, MD a, Heather Powell, MMedSci b, Juan Juan Fu, MD a, b, Lei Wang, MD a, Peter Gerard Gibson, MBBS b, Gang Wang, MD, PhD a, b, c, ⁎ 
Corresponding author: Gang Wang, MD, PhD, Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.Abstract |
Background |
Currently, the cornerstone of asthma management is the achievement and maintenance of optimal asthma control, but the diagnostic performances of the Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ) have not been evaluated systematically.
Objective |
We explored the diagnostic performances of and statistically compared the ACT and ACQ.
Methods |
Studies that examined the accuracy of the ACT, ACQ, or both in the assessment of asthma control were found by searching PubMed, CENTRAL, Web of Science, Ovid, and Embase. Summary estimates of sensitivity, specificity, and diagnostic odds ratios for the different levels of asthma control were determined by using bivariate random-effects models and hierarchical summary receiver operating characteristic models.
Results |
Twenty-one studies with 11,141 subjects assessed with the ACT and 12,483 assessed with the ACQ were identified. The ACT had good diagnostic accuracy for assessment of controlled and not well-controlled asthma, and the ACQ (ACQ-7 and ACQ-6) had good diagnostic accuracy for assessment of not well-controlled asthma at prespecified cutoff points. The ACT and ACQ had significant differences in the assessment of controlled and not well-controlled asthma after adjusting for potential factors (P = .001 and P = .015). For assessment of uncontrolled asthma, the ACT had poor accuracy, with a hierarchical summary receiver operating characteristic area under the curve of 0.69, and the cutoff point for the ACQ has not been established.
Conclusion |
The ACT is preferable to the ACQ in clinical practice, and the ACQ requires further cross-validation. Moreover, neither the ACT nor the ACQ is useful for the assessment of uncontrolled asthma.
Le texte complet de cet article est disponible en PDF.Key words : Global Initiative for Asthma, National Asthma Education and Prevention Program, Asthma Control Test, Asthma Control Questionnaire, diagnostic performance, meta-analysis
Abbreviations used : ACQ, ACT, AUC, DOR, GINA, HSROC, NAEPP, QUADAS-2
Plan
| Supported by the National Natural Science Foundation of China (30971326 and 30901907), the Sichuan Youth Science and Technology Foundation (2010JQ0008), and Youth Science Funding of Sichuan University (2011SCU04B17). |
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| Disclosure of potential conflict of interest: G. Wang has received grants from the National Natural Science Foundation of China, the Sichuan Youth Science and Technology Foundation, Youth Science Funding of Sichuan University; and has received an APSR Research/Training Fellowship (2011) and a scholarship as visiting Associated Professor at the University of Newcastle, Australia. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 131 - N° 3
P. 695-703 - mars 2013 Retour au numéro
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