The Asthma Control Test and Asthma Control Questionnaire for assessing asthma control: Systematic review and meta-analysis.
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.


CONCLUSIONS
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.
Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China.
Chun E
CE
Jia
Hong Ping
HP
Zhang
Yan
Y
Lv
Rui
R
Liang
Yun Qiu
YQ
Jiang
Heather
H
Powell
Juan Juan
JJ
Fu
Lei
L
Wang
Peter Gerard
PG
Gibson
Gang
G
Wang
D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires