title: Development of a nomogram to estimate the quality of life in asthmatic children using the Childhood Asthma Control Test.
abstract: Pediatric Asthma Quality of Life Questionnaire (PAQLQ) provides detailed information on QoL in asthmatic children, whereas Childhood Asthma Control Test (C-ACT) Questionnaire is the most validated instrument for asthma control. No study assessed the relationship between C-ACT and QoL in children by means of those instruments. The aim of this study was to determine whether a QoL estimation is possible using the C-ACT questionnaire in asthmatic children.
  
  
  
  Medical history, spirometry, C-ACT, and PAQLQ were assessed in 144 (60% male) outpatient asthmatic children from September 2011 to November 2014. A generalized linear model (GLM) for the prediction of PAQLQ was obtained through a stepwise procedure starting from a full model with all C-ACT items, and predictive nomograms were created.
  
  
  
  Fifty-five (38%) well-controlled (WC) asthma, 37 (26%) partially controlled (PC) asthma, and 52 (36%) uncontrolled asthma (UA) patients were enrolled. Persistent asthmatics (PA) were significantly more uncontrolled (p < 0.0001). A significant reduction in FEV1 , FEV1 /FVC, and FEF25-75 (p = 0.005, p < 0.0001, and p < 0.001, respectively) was found in WC vs. UA. Through a stepwise process, a reduced model showed a positive relationship between the PAQLQ and the four items of C-ACT. The regression equations for predicted PAQLQ were ln(PAQLQ) = 1.17 + 0.05*C-ACT2 + 0.03*C-ACT3 + 0.04*C-ACT6 + 0.03*C-ACT7. Thus, a nomogram was constructed.
  
  
  
  The designed nomogram provides a highly predictive assessment of QoL in individual patients, facilitating a more comprehensive assessment of asthmatic children in usual clinical care.
authors.affiliation: Institute of Biomedicine and Molecular Immunology, National Research Council of Italy, Palermo, Italy.|Department of Psychological Educational and Training Sciences, University of Palermo, Palermo, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Montalbano
authors.affiliation: Institute of Biomedicine and Molecular Immunology, National Research Council of Italy, Palermo, Italy.|Department of Economics, Statistics and Business Sciences, University of Palermo, Palermo, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cilluffo
authors.affiliation: Institute for Educational Technologies, National Research Council, Palermo, Italy.
authors.forename: Manuel
authors.initials: M
authors.lastname: Gentile
authors.affiliation: Department of Science for Health promotion and Mother and Child care, University of Palermo, Palermo, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Ferrante
authors.affiliation: Institute of Biomedicine and Molecular Immunology, National Research Council of Italy, Palermo, Italy.
authors.forename: Velia
authors.initials: V
authors.lastname: Malizia
authors.affiliation: Institute of Biomedicine and Molecular Immunology, National Research Council of Italy, Palermo, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Cibella
authors.affiliation: Institute of Biomedicine and Molecular Immunology, National Research Council of Italy, Palermo, Italy.|Pulmonary Environmental Epidemiology Unit, Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Viegi
authors.affiliation: Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.affiliation: Institute of Biomedicine and Molecular Immunology, National Research Council of Italy, Palermo, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: La Grutta
mesh_terms: D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D049451:Nomograms; D010372:Pediatrics / Q000639:trends*; D011379:Prognosis; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013147:Spirometry; D011795:Surveys and Questionnaires
keywords: Childhood Asthma Control Test; Pediatric Asthma Quality of Life Questionnaire; asthma; children; control; nomogram