Predictive Properties of the Asthma Control Test and Its Component Questions for Severe Asthma Exacerbations.
Predictive Properties of the Asthma Control Test and Its Component Questions for Severe Asthma Exacerbations.
复制标题
严重哮喘恶化的哮喘控制测试的预测性能及其成分问题。
DOI：
10.1016/j.jaip.2016.06.025
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Williams LK
中科院分区：
文献类型：
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作者：
Cajigal S;Wells KE;Peterson EL;Ahmedani BK;Yang JJ;Kumar R;Burchard EG;Williams LK
Current U.S. guidelines recommend the Asthma Control Test (ACT) for assessing disease control and selecting treatment. The goal of this study was to prospectively assess the ACT and its component questions for their utility in predicting risk of severe asthma exacerbations. Individuals were participants in the Study of Asthma Phenotypes and Pharmacogenomic Interactions by Race-ethnicity (SAPPHIRE), and those included in the current analysis had the following characteristics: age ≥18 years, physician-diagnosed asthma, and longitudinal care received at a large health system in southeastern Michigan. Study participants underwent a baseline evaluation, which included answering the ACT. A severe asthma exacerbation was defined as one requiring oral steroids, an emergency department visit, or inpatient admission. Receiver-operator characteristic curves were used to measure and compare the predictive utility of the ACT and its component questions for severe asthma exacerbations. Of 1,180 participants, 354 (30.0%) experienced a severe asthma exacerbation within 6 months of their baseline evaluation. When compared with the individual questions that composed the ACT, the composite score was significantly better at predicting severe exacerbations with one exception; the composite ACT score and the question assessing rescue medication use were not significantly different (P=0.580). Pharmacy-based records of metered-dose inhaler short-acting beta-agonist use and asthma severity were also not significantly different from the composite ACT score. Our study demonstrates that while the ACT is modestly predictive for exacerbations, the composite score may not be superior to assessing rescue medication use alone for predicting risk of severe asthma exacerbations.
