GINA Versus Childhood Asthma Control Test (CACT), Asthma Control Test (ACT), and Asthma Control Questionnaire (ACQ) to Determine Asthma Control in Children

Background There are several tools to assess the level of control for childhood asthma, but there is a scarcity of data comparing the available tools together in clinical practice. Hence, this study was conducted to determine the performance of the Asthma Control Test (ACT), Childhood ACT (CACT) and Asthma Control Questionnaire (ACQ) in relation to the Global Initiatives for Asthma (GINA) symptom control tool. Methods In this cross‐sectional study, 145 asthmatic children in follow‐up for at least 3 months were enrolled. Control assessment was done using the CACT/ACT, ACQ and GINA control tools together with spirometry at the same visit. Results ACT showed the maximum area under the curve of 0.95, followed by CACT (0.9) and ACQ (0.83). ACT showed a strong agreement with GINA (κ c = 0.79), while CACT and ACQ showed a lower agreement (κ c = 0.52 and 0.51, respectively). CACT at a score of 22 classified well‐controlled asthma with an improved specificity (48.15% to 81.48%), positive predictive value (73.08% to 86.49%), and agreement (0.52 to 0.65) with GINA criteria along with lung function parameters. ACQ and ACT showed the best diagnostic accuracy at a score of 0.93 and 19.5 respectively for well‐controlled asthma. Conclusion The cut‐off for CACT with improved diagnostic accuracy was found to be > 22, which is higher than the recommended cut‐off of > 19. ACT performed best at the originally recommended score of > 19. ACQ performed best at ≤ 0.93 as opposed to the previously recommended score of < 0.75.