Identifying 'well-controlled' and 'not well-controlled' asthma using the Asthma Control Questionnaire
Identifying 'well-controlled' and 'not well-controlled' asthma using the Asthma Control Questionnaire
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DOI：
10.1016/j.rmed.2005.08.012
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发表时间：
2006-04-01
影响因子：
4.3
通讯作者：
Bateman, ED
中科院分区：
文献类型：
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作者：
Juniper, EF;Bousquet, J;Bateman, ED
经验证，7项哮喘控制问卷（ACQ）可用于测量国际指南定义的哮喘管理目标（最大限度地减少日间和夜间症状、活动受限、β（2）-激动剂使用和支气管收缩）。以7分量表给出反应，总评分为反应的平均值（0 =完全控制，6 =严重控制）。本分析的目的是确定ACQ的临界点，该临界点最能区分（a）临床实践（缺失“未良好控制”的低风险）和（B）临床试验（纳入“良好控制”的低风险）的“良好控制”和“未良好控制”。在获得最佳哮喘控制（GOAL）临床试验中提供第12周数据集的所有1323例患者均纳入分析。“良好控制”的金标准是基于GINA/NIH指南的复合物，并来自临床试验日记和临床记录中收集的数据。分析表明，ACQ上“控制良好”和“控制不佳”之间的交叉点接近1.00。然而，为了确信患者的哮喘控制良好，最佳临界点为0.75（阴性预测值= 0.85）。为了确信患者的哮喘控制不佳，最佳临界点为1.50（阳性预测值= 0.88）。总之，这些临界点的知识将提高执业临床医生识别哮喘需要额外治疗的患者的能力，使研究者能够将控制不佳的患者纳入研究，并使临床医生和研究者能够评估是否达到治疗目标。(c)2005爱思唯尔有限公司保留所有权利。
The 7-item Asthma Control Questionnaire (ACQ) has been validated to measure the goals of asthma management as defined by international guidelines (minimisation of day- and night-time symptoms, activity limitation, beta(2)-agonist use and bronchoconstriction). Responses are given on a 7-point scale and the overall score is the mean of the responses (0 = totally controlled, 6 = severely uncontrolled). The aim of this analysis was to determine the cut-point on the ACQ that best differentiates between 'well-controlled' and 'not well-controlled' for (a) clinical practice (low risk of missing 'not well-controlled') and (b) clinical trials (tow risk of including 'well-controlled'). All 1323 patients who provided data sets at week 12 in the Gaining Optimal Asthma Control (GOAL) clinical trial were included in the analysis. The gold standard for 'well-controlled' was a composite based on the GINA/NIH guidelines and derived from data collected in the clinical trial diaries and clinic records. The analysis showed that the crossover point between 'well-controlled' and 'not well-controlled' is close to 1.00 on the ACQ. However, to be confident that a patient has well-controlled asthma, the optimal cut-point is 0.75 (negative predictive value = 0.85). To be confident that the patient has inadequately controlled asthma, the optimal cut-point is 1.50 (positive predictive value = 0.88). In conclusion, knowledge of these cut-points wilt enhance practising clinicians ability to identify patients whose asthma requires additional treatment, enable investigators to enroll poorly controlled patients into studies and for both clinicians and investigators to evaluate whether treatment goals are being achieved. (c) 2005 Elsevier Ltd. All rights reserved.