A clinical evaluation of asthma control test to assess the control of asthma and its relation to the severity of asthma

INTRODUCTION: Bronchial asthma is one of the most common chronic diseases in the world affecting around 5% of the world's population. More simple and inexpensive tools are required to assess asthma control, especially in resource-poor countries where pulmonary function tests are not feasible. The effectiveness of asthma control test (ACT) in assessing asthma control and its correlation with asthma severity is unknown. AIM: The aim of this study is to evaluate the effectiveness of ACT in assessing asthma control and its relation to the severity of asthma by comparing with a global initiative for asthma (GINA) classification. MATERIALS AND METHODS: In a tertiary care hospital, 106 bronchial asthma patients were enrolled. All patients underwent clinical evaluation, spirometry to assess the severity according to the GINA classification and were given ACT questionnaire to assess asthma control. Patients were further followed by two visits 3 months apart. Correlation between the ACT and GINA classification was assessed at each visit. RESULTS: ACT was able to give sensitivity of 82.3%, specificity of 69.4%, positive predictive value (PPV) was 56%, and negative predictive value (NPV) was 89.2% at the first visit (P < 0.05). At the second visit, the sensitivity of the ACT increased to 85.71%, and specificity to 96.77%, PPV was 94.73%, and NPV was 90.90% (P < 0.05). At the third visit, the sensitivity of ACT was 92%, specificity of ACT was 85.18%, PPV was 85.71%, and NPV was 92%, (P < 0.05). CONCLUSIONS: ACT with high sensitivity, specificity, and PPV, could be a potential alternative diagnostic tool in assessing asthma severity even without aid of a spirometer or a peak flow meter.