The Experts below are selected from a list of 11529 Experts worldwide ranked by ideXlab platform
Anja Vaessenverberne - One of the best experts on this subject based on the ideXlab platform.
-
monitoring childhood Asthma web based diaries and the Asthma Control Test
The Journal of Allergy and Clinical Immunology, 2014Co-Authors: Sandra Voorendvan Bergen, Anneke M Landstra, Anja Vaessenverberne, H J L Brackel, Peter J F M Merkus, Norbert J Van Den Berg, Daan Caudri, Johan C De Jongste, Marielle W PijnenburgAbstract:Background Data from Asthma diaries are frequently used as an end point in Asthma studies; however, data on the validity of Web-based diaries are scarce. Objectives First, we examined the validity of a Web-based diary in assessing Asthma Control. Second, we determined the cutoff points for well-Controlled Asthma of the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT), and calculated the minimal important difference for both Tests. Methods Children with Asthma, ages 4-18 years (n = 228) completed a 4-week Web-based diary, C-ACT, ACT, and an Asthma-related quality-of-life questionnaire at baseline and after 1-year follow-up. Results The completion rate of the Web-based diaries was 89%. The diary scores correlated strongly with C-ACT and ACT scores ( r = −0.73, P r = −0.64, P Conclusions Our Web-based diary was valid for recording Asthma symptoms. Cutoff points of ≥22 (C-ACT) and ≥23 (ACT) define well-Controlled Asthma. We recommend a 2 C-ACT and ACT points difference as minimally important.
-
validation of a web based version of the Asthma Control Test and childhood Asthma Control Test
Pediatric Pulmonology, 2011Co-Authors: B B Koolen, Anneke M Landstra, N J Van Den Berg, Wim C J Hop, Marielle W Pijnenburg, H J L Brackel, Peter J F M Merkus, Anja VaessenverberneAbstract:RATIONALE: Recent guidelines focus on adjusting Asthma treatment to the level of Asthma Control. The availability of a web-based Asthma Control questionnaire offers the possibility to assess Asthma Control without the need of outpatient clinic visits. The aim of this study was to evaluate the agreement between web-based and paper-based versions of the Asthma Control Test (ACT) and Childhood Asthma Control Test (C-ACT), short-term reproducibility and satisfaction with both versions. METHODS: One hundred seventy-three children with stable Asthma and a normal lung function were randomized to fill in a web-based or paper-based version of the C-ACT (4-11 years) or ACT (12-18 years). According to a cross-over design, they completed the opposite version after 1 week. Reproducibility was evaluated by repeating the 2nd version (web- or paper-based) 7 days later. RESULTS: Eighty-eight children filled in the C-ACT, 68 children filled in the ACT. Intraclass Correlation Coefficient (ICC) for web-based versus paper-based C-ACT was 0.81 (95% confidence interval [95% CI] 0.72-0.87). For ACT this was 0.84 (95% CI 0.76-0.90). For web-based and paper-based C-ACT the reproducibility ICC was 0.82 (95% CI 0.67-0.90) and 0.75 (95% CI 0.59-0.85), respectively. The reproducibility ICC of the ACT for web- and paper-based versions was 0.93 (95% CI 0.87-0.97) and 0.77 (95% CI 0.59-0.88), respectively. Eighty-six percent of patients preferred the web-based version. CONCLUSION: The web-based version of the C-ACT and ACT is reproducible and comparable with the paper-based version in assessing Asthma Control. Most children and their parents prefer the web-based version. Pediatr. Pulmonol. 2011; 46:941-948. (c) 2011 Wiley-Liss, Inc.
-
comparing global initiative for Asthma gina criteria with the childhood Asthma Control Test c act and Asthma Control Test act
European Respiratory Journal, 2011Co-Authors: B B Koolen, M W H Pijnenburg, Hein J L Brackel, Anneke M Landstra, N J Van Den Berg, P J F M Merkus, Wim C J Hop, Anja VaessenverberneAbstract:Several tools are useful in detecting unControlled Asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting unControlled Asthma in children. 145 children with Asthma filled in a web-based daily diary card for 4 weeks on symptoms, use of rescue medication and limitations of activities, followed by either the C-ACT or ACT. For predicting unControlled Asthma, score cut-off points of 19 were used for C-ACT and ACT. According to GINA guidelines, Asthma was unControlled in 71 (51%) children and completely Controlled in 19 (14%) children. The area under the curve in the receiver operating characteristic curves for C-ACT and ACT versus GINA guidelines were 0.89 and 0.92, respectively. Cut-off points of 19 for C-ACT and ACT resulted in a sensitivity of 33% and 66% in predicting unControlled Asthma, respectively. C-ACT and ACT correlate well with GINA criteria in predicting unControlled Asthma, but commonly used cut-off points for C-ACT and ACT seem to underestimate the proportion of children with unControlled Asthma as defined by GINA.
Krista Todoric - One of the best experts on this subject based on the ideXlab platform.
-
age and african american race impact the validity and reliability of the Asthma Control Test in persistent Asthmatics
Respiratory Research, 2018Co-Authors: Allison J Burbank, Krista Todoric, Pamela H Steele, Jonathan D Rosen, Haibo Zhou, Marcia Frye, Ceila E Loughlin, Sally Ivins, Katherine T Mills, Lauren Dembnicki MasseyAbstract:The Asthma Control Test (ACT) is widely used to assess Asthma Control, yet the validity and reliability of the Test have not been specifically evaluated in adolescents or African-Americans. We conducted a prospective psychometric study of the ACT in African-American (AA) and non-African-American (nAA) adolescents with persistent Asthma, with emphasis on the clinical utility of the Test for medical decision making. Participants completed the ACT and performed spirometry. A physician conducted a guidelines-based assessment of Asthma Control, blinded to the ACT score. Study procedures were repeated 6–8 weeks later. The ACT-based Asthma Control assessment was compared to physician assessment. For baseline and follow-up visits, internal consistency, as measured using Cronbach’s alpha, was 0.80 and 0.81 in AA teens and 0.80 and 0.83 in nAA teens. Intraclass correlation coefficients were 0.59 and 0.76 in AA and nAA teens, respectively, with stable Asthma Control over time. Agreement between ACT and physician assessment was moderate in AA teens and fair in nAA teens. An ACT score of ≤19 showed reduced sensitivity for not well Controlled Asthma in both groups, while a score of ≤21 had the greaTest area under the ROC curve. ACT scores were marginally responsive to change in Control status. Concerns for the ACT’s ability to detect unControlled Asthma in adolescents emphasizes the need for a more comprehensive evaluation of Asthma Control in clinical settings. A higher threshold ACT score to define not well Controlled Asthma may be needed if the ACT is to be used for medical decision making. ClinicalTrials.gov: NCT02671643 , NCT02662413 .
-
assessing Asthma in african american children using the Asthma Control Test and the childhood Asthma Control Test
Annals of Allergy Asthma & Immunology, 2015Co-Authors: Krista Todoric, Shrikant I Bangdiwala, Anusha Vadlamudi, Lisa Alarcon, Michelle L HernandezAbstract:African Americans disproportionally experience unControlled Asthma1. Because Asthma Control is now the focus of Asthma management,2 publicly available questionnaires like the Asthma Control Test™ (ACT)3 and childhood Asthma Control Test (ACTc)4 represent the most accessible, standardized, non-physician methods of assessing Control and are typically considered cost-effective and easily implemented Asthma care strategies for primary care offices. Both the ACT (≥12 years old) and ACTc (<12 years old) query Asthma symptoms over the past four weeks and use a cutpoint of ≤ 19 for not well-Controlled Asthma3–4. Because neither questionnaire has been validated in African American children5–10, we sought to determine whether the ACT and the ACTc are appropriate screening tools for Asthma Control in this population. This retrospective study was approved by the University of North Carolina Institutional Review Board. From a list maintained by an Asthma educator for all pediatric Asthma patients seen either at the pulmonology or allergy/immunology clinics, we reviewed the medical record and included data from all children who met the following inclusion criteria: self-identified African-American, ages 5–18, and had at least 2 visits for which ACT/c and spirometry were both performed between January 1, 2011 and November 1, 2013. Fifty-seven children were identified. The primary author reviewed charts from each visit and determined physician-assessment of Asthma Control by either 1) provider’s written explicit determination of Control or, if this were not available, 2) reviewing medication management strategies (classifying continuation of current management or de-escalation of therapy as “well-Controlled” and the escalation of therapy as “not well-Controlled”). Although investigators were not blinded to spirometry and ACT/c scores, these values were, in most cases, collected by a second investigator independent of chart review for Asthma Control. By this method, we collected a total of 130 observations/visits with 84 visits in 41 children ≥12 years old (45 well-Controlled visits and 39 not well-Controlled visits by MD assessment) and 46 visits in 22 children 19 with physician assessment of Control using measures of sensitivity, specificity, and Cohen’s kappa. A receiver-operating curve was used to determine the best ACT cutpoint for assessment of Control in this population. A logistic regression model was used with ‘Control by physician’ as the dependent variable and ‘ACT score’ as the independent variable. This model included as potential confounders FEV1 and FEV1/FVC (dichotomized at 80%) and age of the child (age <12 or ≥12) as a potential moderator of the effect of ACT score. These models also included a random intercept effect for child in order to account for the correlation among the repeated measures in a child. Adolescents ages 12–18 years with Controlled Asthma by physician assessment had higher ACT scores than those without Controlled Asthma (p 19 was strongly associated with physician-assessment of Control in this group (Fisher’s exact 80% (kappa=0.20, p=0.0317). Figure 1 Receiver operating curve showing ACT scores compared to MD Control assessment in children ≥12yo. When reviewing the entire data set of children ages 5–18 years old, logistic regression demonstrated that higher ACT scores are associated with increased odds of one’s Asthma being classified as Controlled by MD assessment (p=0.0001). However, older age (being ≥12 compared to 19 for Asthma Control using the ACTc was not associated with physician assessment of Control (Fisher’s exact=0.3883) and did not agree with spirometry-measured Control defined by FEV1>80% (kappa=0.34, p=0.0095). Additionally, a cutpoint of >19 only had a sensitivity of 50% and a specificity of 64% in these younger children. In this study, we demonstrate that the ACTc as currently used may not accurately predict Asthma Control in African American children < 12-years-old, showing limited functionality in this group with low sensitivity and specificity for mirroring the gold standard of physician assessment of Asthma Control. Surprisingly, this points to a clear discrepancy between caregiver and provider perception of Asthma Control in children < 12 years old. While the ACTc queries both child and caregiver, greater weight is given to those caregiver-answered questions. Hence, failure of a caregiver to recognize not well-Controlled Asthma has implications for impacting Asthma treatment plans and may also contribute to the increased risks of morbidity and mortality associated with unControlled Asthma in this population. Although the ACT had better performance in children ≥12-years-old (who do fill out their own questionnaires), we also found that sensitivity for determining Asthma Control could be increased by changing the ACT cutpoint to 18 rather than >19 (with a previously reported sensitivity of 71.3% and specificity of 70.8% in a primarily Caucasian population6). Limitations to our study include its retrospective nature, small sample size, unknown impact of socioeconomic status or the nature of the visit (scheduled versus urgent care), and possible investigator bias (non-blinding to ACT/c and spirometry results). Overall, our results suggest that current use of the ACT and ACTc may require adjustment to better correlate with physician assessment of Asthma Control in African American children. Additional prospective studies are required to further explore these findings and inform alternate clinical practice standards.
Takashi Hasegawa - One of the best experts on this subject based on the ideXlab platform.
-
depression s influence on the Asthma Control Test japanese version
Allergology International, 2014Co-Authors: Mio Toyama, Takashi Hasegawa, Takuro Sakagami, Toshiyuki Koya, Masachika Hayashi, Hiroshi Kagamu, Yoshiyuki Muramatsu, Kumiko Muramatsu, Masaaki Arakawa, Fumitake GejyoAbstract:ABSTRACT Background Depression has been linked to poorer Asthma Control in Asthmatic patients. Although the Japanese version of the Asthma Control Test (ACT-J) is frequently used as a simple, practical evaluation tool in clinical care settings in Japan, knowledge regarding its efficacy for assessing Asthma Control in Asthmatic patients with depression is limited. Thus, we retrospectively investigated cut-off values of the ACT-J for well- Controlled Asthma, and explored depression's influence on the Test with a questionnaire survey. Methods Data were analyzed on 1,962 adult Asthmatic patients who had completed both the ACT-J and the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) in 2008 questionnaire survey conducted by the Niigata Asthma Treatment Study Group. Patients were classified into low (LD: J-PHQ-9 score of 0-4) or high depression (HD: J-PHQ-9 score of 5-27) groups. In both groups, the efficacy of the ACT-J was confirmed. We then compared the optimal cut-off points for unControlled Asthma in both groups by performing a receiver operating characteristic (ROC) analysis, using the original classification referred to the GlNA classification as the "true" classification. Results Cronbach's alpha in the LD and HD group was 0.808 and 0.740 respectively. In both groups, the subgroup with existence of work absenteeism or frequent attacks during the previous 12 months scored lower on the ACT-J. The area under the curve and optimal cut-off point for patients with LD and HD were 0.821 and 0.846, and 23 and 20 respectively. Conclusions The efficacy of the ACT-J was confirmed in depressive patients with Asthma. Because Asthma Control as evaluated with the ACT-J can be worse than actual Control under depressive states, physicians should also pay attention to a patient's depressive state at evaluation. Further investigations focus on the association between the ACT-J and depression are required.
-
the Asthma Control Test japanese version act j as a predictor of global initiative for Asthma gina guideline defined Asthma Control analysis of a questionnaire based survey
Allergology International, 2013Co-Authors: Takashi Hasegawa, Takuro Sakagami, Toshiyuki Koya, Hiroshi Kagamu, Masaaki Arakawa, Fumitake Gejyo, Ichiei Narita, Eiichi SuzukiAbstract:BACKGROUND: The 2006 Global Initiative for Asthma (GINA 2006) guidelines emphasize the importance of evaluating the Control rather than the severity of Asthma. The Asthma Control Test (ACT) is well known to be an excellent tool for evaluating Asthma Control in the clinical setting. This study aimed to evaluate the ACT, Japanese version (ACT-J) as a predictor of Asthma Control as defined by the GINA 2006 guidelines in actual clinical practice. METHODS: A cross-sectional analysis comparing the ACT-J score and GINA classification of Asthma Control among 419 patients of primary care physicians and specialists was performed using the data from a 2010 questionnaire-based survey conducted by the Niigata Asthma Treatment Study Group. RESULTS: The optimal cut-off point of the ACT-J score for predicting GINA-defined Asthma Control was 23, with ACT-J scores of ≥23 and ≤22 predicting Controlled and unControlled Asthma with area under the receiver operating characteristics curve values of 0.76 [95% confidence interval (CI): 0.72-0.81] and 0.93 [95% CI: 0.90-0.97], respectively. CONCLUSIONS: ACT scores of ≥23 and ≤22 are useful for identifying patients with Controlled and unControlled Asthma, respectively, as defined by GINA 2006, and the latter is more strongly predictive than the former. The reason for the higher cut-off point of the ACT-J relative to other versions of the ACT is unclear and warrants further investigation.
-
efficacy of using the japanese version of the Asthma Control Test for determing the level of Asthma Control in clinical settings
Allergology International, 2012Co-Authors: Takashi Hasegawa, Takuro Sakagami, Toshiyuki Koya, Hiroshi Kagamu, Masaaki Arakawa, Fumitake Gejyo, Hidenori Kawakami, Katsuhito Hara, Fumitoshi Yoshimine, Ichiei NaritaAbstract:ABSTRACT Background: The Asthma Control Test (ACT) is frequently used for the evaluation of Asthma Control in clinical care setting because it does not require the use of pulmonary function Tests, which can be difficult for general practitioners to use. However, few large-scale studies have investigated the efficacy of the Japanese version ACT (J-ACT) in actual use during clinical care. Methods: The aim of this study was to analyze the efficacy of the J-ACT in a clinical care setting. Using data from a 2008 questionnaire survey including the J-ACT by the Niigata Asthma Treatment Study Group, we compared the ACT scores of 2233 patients with respect to multiple parameters, including the severity by Japanese Society of Allergology and the attack frequency. Using the definition of Asthma Control partially referred to Global Initiative for Asthma (GINA) guidelines from the survey data, the accuracy screening and determination of optimal ACT cutpoints were performed by retrospective analysis. Results: Cronbach's a for the J-ACT was 0.785. Patients with more severe Asthma and more frequent Asthma attacks had lower ACT scores than did patients with less severe, less frequent attacks. The optimal ACT cutpoints were 24 for the Controlled Asthma and 20 for the unControlled Asthma. Conclusions: Our study, the first large-scale investigation of the efficacy of the J-ACT, determined that this evaluation tool is highly efficacious in establishing the level of Asthma Control. However, the determination of accurate cutpoints for the J-ACT will require more clear definitions of Asthma Control in future prospective studies.
Fumitake Gejyo - One of the best experts on this subject based on the ideXlab platform.
-
depression s influence on the Asthma Control Test japanese version
Allergology International, 2014Co-Authors: Mio Toyama, Takashi Hasegawa, Takuro Sakagami, Toshiyuki Koya, Masachika Hayashi, Hiroshi Kagamu, Yoshiyuki Muramatsu, Kumiko Muramatsu, Masaaki Arakawa, Fumitake GejyoAbstract:ABSTRACT Background Depression has been linked to poorer Asthma Control in Asthmatic patients. Although the Japanese version of the Asthma Control Test (ACT-J) is frequently used as a simple, practical evaluation tool in clinical care settings in Japan, knowledge regarding its efficacy for assessing Asthma Control in Asthmatic patients with depression is limited. Thus, we retrospectively investigated cut-off values of the ACT-J for well- Controlled Asthma, and explored depression's influence on the Test with a questionnaire survey. Methods Data were analyzed on 1,962 adult Asthmatic patients who had completed both the ACT-J and the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) in 2008 questionnaire survey conducted by the Niigata Asthma Treatment Study Group. Patients were classified into low (LD: J-PHQ-9 score of 0-4) or high depression (HD: J-PHQ-9 score of 5-27) groups. In both groups, the efficacy of the ACT-J was confirmed. We then compared the optimal cut-off points for unControlled Asthma in both groups by performing a receiver operating characteristic (ROC) analysis, using the original classification referred to the GlNA classification as the "true" classification. Results Cronbach's alpha in the LD and HD group was 0.808 and 0.740 respectively. In both groups, the subgroup with existence of work absenteeism or frequent attacks during the previous 12 months scored lower on the ACT-J. The area under the curve and optimal cut-off point for patients with LD and HD were 0.821 and 0.846, and 23 and 20 respectively. Conclusions The efficacy of the ACT-J was confirmed in depressive patients with Asthma. Because Asthma Control as evaluated with the ACT-J can be worse than actual Control under depressive states, physicians should also pay attention to a patient's depressive state at evaluation. Further investigations focus on the association between the ACT-J and depression are required.
-
the Asthma Control Test japanese version act j as a predictor of global initiative for Asthma gina guideline defined Asthma Control analysis of a questionnaire based survey
Allergology International, 2013Co-Authors: Takashi Hasegawa, Takuro Sakagami, Toshiyuki Koya, Hiroshi Kagamu, Masaaki Arakawa, Fumitake Gejyo, Ichiei Narita, Eiichi SuzukiAbstract:BACKGROUND: The 2006 Global Initiative for Asthma (GINA 2006) guidelines emphasize the importance of evaluating the Control rather than the severity of Asthma. The Asthma Control Test (ACT) is well known to be an excellent tool for evaluating Asthma Control in the clinical setting. This study aimed to evaluate the ACT, Japanese version (ACT-J) as a predictor of Asthma Control as defined by the GINA 2006 guidelines in actual clinical practice. METHODS: A cross-sectional analysis comparing the ACT-J score and GINA classification of Asthma Control among 419 patients of primary care physicians and specialists was performed using the data from a 2010 questionnaire-based survey conducted by the Niigata Asthma Treatment Study Group. RESULTS: The optimal cut-off point of the ACT-J score for predicting GINA-defined Asthma Control was 23, with ACT-J scores of ≥23 and ≤22 predicting Controlled and unControlled Asthma with area under the receiver operating characteristics curve values of 0.76 [95% confidence interval (CI): 0.72-0.81] and 0.93 [95% CI: 0.90-0.97], respectively. CONCLUSIONS: ACT scores of ≥23 and ≤22 are useful for identifying patients with Controlled and unControlled Asthma, respectively, as defined by GINA 2006, and the latter is more strongly predictive than the former. The reason for the higher cut-off point of the ACT-J relative to other versions of the ACT is unclear and warrants further investigation.
-
efficacy of using the japanese version of the Asthma Control Test for determing the level of Asthma Control in clinical settings
Allergology International, 2012Co-Authors: Takashi Hasegawa, Takuro Sakagami, Toshiyuki Koya, Hiroshi Kagamu, Masaaki Arakawa, Fumitake Gejyo, Hidenori Kawakami, Katsuhito Hara, Fumitoshi Yoshimine, Ichiei NaritaAbstract:ABSTRACT Background: The Asthma Control Test (ACT) is frequently used for the evaluation of Asthma Control in clinical care setting because it does not require the use of pulmonary function Tests, which can be difficult for general practitioners to use. However, few large-scale studies have investigated the efficacy of the Japanese version ACT (J-ACT) in actual use during clinical care. Methods: The aim of this study was to analyze the efficacy of the J-ACT in a clinical care setting. Using data from a 2008 questionnaire survey including the J-ACT by the Niigata Asthma Treatment Study Group, we compared the ACT scores of 2233 patients with respect to multiple parameters, including the severity by Japanese Society of Allergology and the attack frequency. Using the definition of Asthma Control partially referred to Global Initiative for Asthma (GINA) guidelines from the survey data, the accuracy screening and determination of optimal ACT cutpoints were performed by retrospective analysis. Results: Cronbach's a for the J-ACT was 0.785. Patients with more severe Asthma and more frequent Asthma attacks had lower ACT scores than did patients with less severe, less frequent attacks. The optimal ACT cutpoints were 24 for the Controlled Asthma and 20 for the unControlled Asthma. Conclusions: Our study, the first large-scale investigation of the efficacy of the J-ACT, determined that this evaluation tool is highly efficacious in establishing the level of Asthma Control. However, the determination of accurate cutpoints for the J-ACT will require more clear definitions of Asthma Control in future prospective studies.
Mark Kosinski - One of the best experts on this subject based on the ideXlab platform.
-
a structured review evaluating content validity of the Asthma Control Test and its consistency with u s guidelines and patient expectations for Asthma Control
Journal of Asthma, 2020Co-Authors: Linda Nelsen, Mark Kosinski, Michael Schatz, Avery A Rizio, Loretta Jacques, Richard H Stanford, Henrik SvedsaterAbstract:To assess whether the content of the Asthma Control Test (ACT) served as a valid measure of Asthma Control (i.e., content validity) by mapping ACT items to the National Heart, Lung and Blood Instit...
-
the minimally important difference of the Asthma Control Test
The Journal of Allergy and Clinical Immunology, 2009Co-Authors: Michael Schatz, Mark Kosinski, Aaron Yarlas, Jennifer T Hanlon, Maria E Watson, Priti JhingranAbstract:Background The Asthma Control Test (ACT) has been well validated, but a minimally important difference (MID) has not been established. Objective We sought to identify an MID for the ACT. Methods Data come from 4 independent samples of adult Asthmatic patients. Distributional methods for determining the MID included 0.5 SD, 1 SEM, and 2 SEM. Anchor-based methods assessed the relationship of differences in ACT scores to (1) self-reported Asthma severity, (2) Asthma episode frequency in the past 4 weeks, (3) physician ratings of Asthma Control, (4) physician recommendation of a change in therapy, (5) FEV 1 , (6) the risk over the next 12 months of excess short-acting β-agonist use and exacerbations, and (7) patient-defined changes in Asthma course over 3 months. Results Four thousand one hundred eighteen patients completed the ACT. The 0.5 SD criterion for MID ranged from 2.03 to 2.45 points (mean, 2.2 points). The 1 SEM criterion ranged from 1.77 to 2.05 points (mean, 1.88 points), and the 2 SEM criterion ranged from 3.55 to 4.10 points (mean, 3.75 points). Differences in mean ACT scores across patient groups differing on criterion measures ranged from 1.06 to 5.28 points (mean, 3.1 points). Predictive analyses showed that a difference of 3 points on the ACT was associated with a subsequent 76% increased risk (95% CI, 73% to 79%) of excess short-acting β-agonist use and a 33% increased risk (95% CI, 31% to 35%) of exacerbations. Conclusion The data support an MID for the ACT of 3 points.
-
comparability of the Asthma Control Test telephone interview administration format with self administered mail out mail back format
Current Medical Research and Opinion, 2009Co-Authors: Mark Kosinski, Anita Kite, Min Yang, Jacqueline Carranza Rosenzweig, Angela E WilliamsAbstract:ABSTRACTObjective: The aim of this study was to evaluate the comparability of ACT scores from a telephone interview format (‘Telephone’) against the original paper-and-pencil format (‘Paper’). * Asthma Control Test (ACT) is a registered trademark of QualityMetric Incorporated, Lincoln, RI, USAMethods: This was a randomized, crossover design with subjects completing both paper and telephone interview questionnaires. Subjects were ≥18 years old, with an Asthma diagnosis, and receiving treatment within the last year. Eligible subjects were randomized to one of four administration form (AF) groups – (1) Telephone–Telephone, (2) Paper–Paper, (3) Paper–Telephone, (4) Telephone–Paper. Internal consistency and Test–reTest reliability were compared across groups. Differential item functioning (DIF) Tests were conducted at baseline to evaluate AF effects on individual ACT items. Unadjusted and adjusted mean ACT scores were compared between AFs at baseline and unadjusted and adjusted means changes in ACT scores from...
-
validity of the Asthma Control Test completed at home
The American Journal of Managed Care, 2007Co-Authors: Michael Schatz, Mark Kosinski, David M Mosen, William M Vollmer, David J Magid, Elizabeth Oconnor, Robert S ZeigerAbstract:Objective To provide additional validity data for the Asthma Control TestTM (ACT) using a different criterion measure, setting, and population. Study design Cross-sectional survey. Methods Questionnaires were completed at home by a random sample of 570 members of a large integrated healthcare organization who were 35 years or older with utilization suggestive of active Asthma. The questionnaires included the ACT; another validated Asthma Control questionnaire (Asthma Therapy Assessment Questionnaire [ATAQ]), which was used as the criterion measure; a validated quality-of-life tool (Mini Asthma Quality of Life Questionnaire [Mini-AQLQ]); a validated symptom frequency scale (Asthma Outcomes Monitoring System); and information regarding demographics. Results The ACT score was statistically significantly correlated with findings on the ATAQ (P = -0.73), Mini-AQLQ (P = 0.77), and symptom frequency scale (P = -0.69). The optimal ACT cutoff for well-Controlled Asthma (ATAQ level, 0) was confirmed to be 20 or higher (sensitivity, 78.1%; specificity, 83.8%), and the optimal ACT cutoff for poorly Controlled Asthma (ATAQ level, 3-4) was confirmed to be 15 or lower (sensitivity, 90.4%; specificity, 80.9%). Conclusion These data further support the validity of the ACT in the home setting among a random sample of patients with Asthma.
-
reliability and predictive validity of the Asthma Control Test administered by telephone calls using speech recognition technology
The Journal of Allergy and Clinical Immunology, 2007Co-Authors: Michael Schatz, Robert S Zeiger, Alexandra Drane, Kathleen Harden, Aysel Cibildak, Jon E Oosterman, Mark KosinskiAbstract:Background The Asthma Control Test (ACT) has been validated in a paper and pencil version but has not been validated for use by telephone. Objective The purpose of this study was to provide validation data for the ACT administered by interactive telephone calls using speech recognition technology. Methods The ACT was administered to patients who confirmed a diagnosis of physician-diagnosed Asthma, and information regarding race/ethnicity, smoking, and Asthma course was also obtained during the call. Asthma emergency department visits, hospitalizations, and oral corticosteroid and β-agonist canister dispensings were assessed for the 12 months after the date of each patient's call. Internal consistency reliability and predictive validity were assessed. Results Asthma Control Test scores (higher indicates better Control) were completed by 2244 patients and were inversely related to black or Hispanic race/ethnicity and smoking. Reliability was 0.83. ACT scores were significantly related to emergency hospital care and oral corticosteroid and β-agonist dispensings over the period of the subsequent 6 and 12 months. After adjusting for demographic characteristics, a score ≤ 15 was associated significantly with an increased 12-month risk of emergency hospital care (odds ratio [OR], 2.5), oral corticosteroid dispensings (OR, 2.6) and dispensing of more than 6 β-agonist canisters (OR, 6.8) compared with a score ≥ 20. Conclusion These data support the reliability and predictive validity of the ACT administered by interactive telephone calls using speech recognition technology. Clinical implications The ACT can be used for outreach or follow-up by means of interactive telephone calls using speech recognition technology.
