Validity of the Asthma Control Test Questionnaire among Smoking Asthmatics

Xavier Soler, Janet T. Holbrook, Lynn B Gerald, Cristine E Berry, Joy Saams, Robert J. Henderson, Elizabeth Sugar, Robert A. Wise, Joe W. Ramsdell

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Smoking asthmatics respond worse to existing asthma therapies and have more asthma symptoms and exacerbations. Objective: We evaluated the Asthma Control Test (ACT) for assessing asthma control among smokers. Methods: Adults with asthma who smoked were enrolled and followed for 6 weeks. The statistical properties, validity, and responsiveness of the ACT were evaluated. Physician global assessment (GS) of asthma was the "gold standard.". Results: A total of 151 participants were enrolled: 52% female and 48% male. The median (interquartile ranges) was 35 (27, 43) years for age, 11 (7, 18) for pack-years, and 16 (13, 20) for the ACT score. Participants self-identified as African American (49%), non-Hispanic whites (38%), and Hispanic whites (11%). Participants were classified as well controlled (24%), not well controlled (42%), or very poorly controlled (34%) at enrollment. Cronbach's alpha (95% confidence interval [CI]) for the ACT at enrollment was 0.81 (0.76, 0.85). The intraclass correlation coefficient (95% CI) for agreement of scores at enrollment and 6 weeks was 0.68 (0.57, 0.78) in participant with stable asthma (n = 93). ACT scores were associated with GS (P < .001). Area under the receiver operating characteristic (ROC) curve (95% CI) for an ACT cutoff score of ≤19 (not well controlled) was 0.76 (0.67, 0.84). The ACT score with the maximum area under the ROC curve was 18.6. Conclusions: The ACT questionnaire was reliable and discriminated between levels of asthma control in smoking asthmatics with similar sensitivity and specificity as nonsmoking asthmatics, which confirms its value as a tool for the management of asthma in this prevalent but understudied subgroup of subjects.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology: In Practice
DOIs
StateAccepted/In press - 2017

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Asthma
Smoking
Surveys and Questionnaires
Confidence Intervals
ROC Curve
Hispanic Americans
African Americans
Physicians
Sensitivity and Specificity

Keywords

  • ACT
  • Asthma
  • Asthma Control Test
  • Smoking

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Validity of the Asthma Control Test Questionnaire among Smoking Asthmatics. / Soler, Xavier; Holbrook, Janet T.; Gerald, Lynn B; Berry, Cristine E; Saams, Joy; Henderson, Robert J.; Sugar, Elizabeth; Wise, Robert A.; Ramsdell, Joe W.

In: Journal of Allergy and Clinical Immunology: In Practice, 2017.

Research output: Contribution to journalArticle

Soler, Xavier ; Holbrook, Janet T. ; Gerald, Lynn B ; Berry, Cristine E ; Saams, Joy ; Henderson, Robert J. ; Sugar, Elizabeth ; Wise, Robert A. ; Ramsdell, Joe W. / Validity of the Asthma Control Test Questionnaire among Smoking Asthmatics. In: Journal of Allergy and Clinical Immunology: In Practice. 2017.
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