title: Assessing asthma control: symptom scores, GINA levels of asthma control, lung function, and exhaled nitric oxide.
abstract: BACKGROUND
  The childhood asthma control test (C-ACT) is a validated symptom score for assessing asthma control in children. We used a slightly modified version (C-ACT(M) ) of the German C-ACT and compared our results with the literature, correlated the children's part of C-ACT (C-ACT(children) ) with a visual analogue scale (VAS(children) ), explored the agreement between C-ACT(M) and GINA levels of asthma control, as well as the relationship between C-ACT(M) and lung function and exhaled nitric oxide (FeNO).
  
  
  METHODS
  We investigated 107 children with a diagnosis of asthma. The study protocol consisted of a clinical examination, assessment of asthma control according to GINA guidelines, administration of C-ACT(M) , VAS(children) , lung function, and FeNO.
  
  
  RESULTS
  Of our patients 66% had, according to GINA, partly controlled-/uncontrolled asthma, 18% were uncontrolled according to C-ACT(M) . Children with partly controlled-/uncontrolled asthma according to GINA had lower C-ACT(M) scores than did children with controlled asthma (16.1 ± 3.6 SD vs. 25.4 ± 1.8 SD; P < 0.000), and children with a C-ACT(M) score ≤ 19 had poorer lung function (mean FEV1% predicted 81.5 ± 13.5 SD vs. 94.2 ± 12.1 SD; P = 0.002). Spearman's rank correlation coefficients revealed significant correlations between all symptom scores. Multiple linear regression adjusted for age, gender, FEV1 and FeNO demonstrated a significant relationship between C-ACT(M) , VAS(children) , and FEV1 (P = 0.003, resp. <0.000), but no significant correlation between C-ACT(M) , VAS(children) , and FeNO.
  
  
  CONCLUSIONS
  The German version of C-ACT(M) is valid and useful for monitoring children with asthma along with tests aimed to follow up lung function and airway inflammation. Concordance between C-ACT(M) and GINA is moderate, because asthma control assessed by C-ACT(M) allows more symptoms and lung function is not included in the scoring.
authors.affiliation: University Hospital for Children and Adolescents, Innsbruck Medical University, Innsbruck, Austria. vanessa.waibel@i-med.ac.at
authors.forename: Vanessa
authors.initials: V
authors.lastname: Waibel
authors.forename: Hanno
authors.initials: H
authors.lastname: Ulmer
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Horak
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology*; D001944:Breath Tests; D002648:Child; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009569:Nitric Oxide / Q000032:analysis / Q000502:physiology*; D012129:Respiratory Function Tests; D012720:Severity of Illness Index
chemical_list: D009569:Nitric Oxide