Assessment of Asthma Control by Correlation of Asthma Control Test and GINA Criteria

比較使用氣喘控制測驗及GINA準則對氣喘控制程度評估的相關性

趙志浩(Chih-Hao Chao) ； 金湘玲(Shiang-Ling King) ； 王振宇(Chen-Yu Wang) ； 詹明澄(Ming-Cheng Chan) ； 郭英調(Benjamin I Kuo) ； 許正園(Jeng-Yuan Hsu)

《胸腔醫學》 23卷2期 (2008/04) Pp. 81-88

https://doi.org/10.29806/TM.200804.0002

摘要

前言：GINA氣喘準則指出，評估氣喘控制程度要包括日間及夜間症狀、活動受限狀況、使用急救藥物的次數、急性發作的頻率以及肺功能試驗或是尖峰流速的結果。一個最近被提出的方法－氣喘控制測驗(ACT)，是種由病人自行填寫的問卷，其中包含了五個問題，可由問卷評分的結果簡單地評估氣喘控制狀況。本研究目的在比較使用這兩種不同方法對評估氣喘控制程度的關聯性，以確定ACT在臨床上的實用性。
方法：規則於門診追蹤的氣喘病人完成ACT後即加入此研究。ACT依分數將病人分為三組，25分為完全控制，20-24分為控制良好，小於20分為控制不良。
結果：總共116位病人，233次門診中，ACT和GINA準則有良好的關聯性。71.7%的病人有完全相關(agreement Kappa=.524)。分別有15.5%及12.9%的病人高估及低估了自身氣喘的控制。進一步分析發現在沒有抽煙病史的病人中可得到較好的agreement Kappa值。
結論：ACT和GINA準則對氣喘控制程度的評估上有良好的關聯性，然而還是有些病人高或低估了他們的疾病。本研究結果支持ACT可當作病人在門診追蹤時可選用的一種工具。

關鍵字

氣喘 ； 氣喘控制測驗

並列摘要

Background and objective: The GINA asthma guidelines indicate that the rating of asthma control should include the daytime and nocturnal symptoms, limitations of activities, need for rescue treatment, frequency of exacerbations, and measurement of spirometry or peak flow rates. The Asthma Control Test (ACT(superscript TM)), a recently devised tool, evaluates asthma control simply, using a 5-item, self-administered questionnaire. To ensure the clinical applicability of the ACT, we evaluated the correlation of the ACT and the GINA rating criteria in assessing asthma control in our asthmatic patients.
Methods: Asthmatic patients with regular outpatient follow-up at our clinic who completed the ACT were enrolled into this study. The patients were classified according to their ACT questionnaire score: 25 as total control, 20 to 24 as well controlled, and less than 20 as not well controlled.
Results: Among the 116 patients, who accounted for a total of 233 visits, there was a significant correlation between the ACT control level and the GINA rating criteria in assessing asthma control. Complete agreement was observed in 71.7% (kappa agreement=.524). There was a 15.5% and 12.9% over- and underestimation, respectively, of asthma control status by the patients themselves. Sub-group analysis showed a better kappa agreement value in the non-smoking patients.
Conclusions: The ACT correlates well with the GINA rating criteria in assessing asthma control, although some disagreements may still persist. The results of this study confirm that the ACT is a convenient alternative screening tool for use in outpatient follow-up.

並列關鍵字

asthma ； asthma control test