What are the best estimates of pediatric asthma control?
OBJECTIVE
To evaluate asthma outcome measures in the face of the variable nature of asthma. The outcome measures are divided into objective and subjective clinical measures, humanistic measures such as quality of life, and costs of asthma control.


RESULTS
Objective measures of asthma include those traditionally used such as spirometry, peak expiratory flow rate, and airway hyperresponsiveness. Recently, more attention has been geared towards markers of inflammation including exhaled nitric oxide and sputum eosinophils. Subjective measures of asthma control include patient-derived parameters such as number of wheezing episodes, nocturnal symptoms, exercise-induced symptoms, short-acting beta-agonist use, steroid bursts, emergency-department visits, and hospitalizations. Asthma-related quality of life is related to asthma morbidity, and patients with better baseline quality of life have improved outcomes. Asthma-related costs include direct costs mostly comprised of hospitalizations and emergency-room visits, and indirect costs including school absenteeism.


CONCLUSIONS
There is no ideal outcome measure for evaluating pediatric asthma control, but each of these outcome measures must be used together to evaluate a patient at each outpatient visit. Patient-centered measures of asthma control must also be further incorporated into office visits for improved asthma management.
Gandhi
Radha K
RK
Department of Clinical Allergy and Immunology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Blaiss
Michael S
MS
D001249:Asthma / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D017063:Outcome Assessment, Health Care / Q000379:methods; D010366:Peak Expiratory Flow Rate; D013147:Spirometry / Q000379:methods
D009569:Nitric Oxide