Cited by 1,221Asthma and respiratory diseasesChronic Obstructive Pulmonary Disease (COPD) ResearchOccupational exposure and asthma

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Asthma Control Test: Reliability, validity, and responsiveness in patients not previously followed by asthma specialists

Schatz, Michael, Sorkness, Christine A., Li, James T., Marcus, Philip, Murray, John J., Nathan, Robert A., Kosinski, Mark, Pendergraft, Trudy B., Jhingran, Priti·2006·Journal of Allergy and Clinical Immunology

DOI 10.1016/j.jaci.2006.01.011

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Abstract

Background The development of the Asthma Control Test (ACT), a short, simple, patient-based tool for identifying patients with poorly controlled asthma, was recently described in patients under the routine care of an asthma specialist.Objectives We sought to evaluate the reliability and validity of the ACT in a longitudinal study of asthmatic patients new to the care of an asthma specialist.Methods Patients (n=313) completed the ACT and the Asthma Control Questionnaire (ACQ) at 2 physician visits (4-12 weeks apart). Pulmonary function was measured, and asthma specialists rated asthma control.Results Internal consistency reliability of the ACT was 0.85 (baseline) and 0.79 (follow-up). Test-retest reliability was 0.77. Criterion validity was demonstrated by significant correlations between baseline ACT scores and baseline specialists' ratings of asthma control (r=0.52, P<.001) and ACQ scores (r=-0.89, P<.001). Discriminant validity was demonstrated, with significant (P<.001) differences in mean ACT scores across patients differing in asthma control, pulmonary function, and treatment recommendation. Responsiveness of the ACT to changes in asthma control and lung function was demonstrated with significant correlations between changes in ACT scores and changes in specialists' ratings (r=0.44, P<.001), ACQ scores (r=-0.69, P<.001), and percent predicted FEV1 values (r=0.29, P<.001). An ACT score of 19 or less provided optimum balance of sensitivity (71%) and specificity (71%) for detecting uncontrolled asthma.Conclusions The ACT is reliable, valid, and responsive to changes in asthma control over time in patients new to the care of asthma specialists. A cutoff score of 19 or less identifies patients with poorly controlled asthma.Clinical implications In a clinical setting the ACT should be a useful tool to help physicians identify patients with uncontrolled asthma and facilitate their ability to follow patients' progress with treatment.

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Background
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Method
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Authors: Schatz, M., Sorkness, C. A., Li, J. T., Marcus, P., Murray, J. J., Nathan, R. A., Kosinski, M., Pendergraft, T. B., & Jhingran, P.
Affiliations: Kaiser Permanente (US)
University of Wisconsin–Madison (US)
Mayo Clinic (US)
Vanderbilt University (US)
Corresponding author: Schatz, Michael
ORCID: Sorkness, Christine A.
Murray, John J.
Kosinski, Mark
Venue: Journal of Allergy and Clinical Immunology
Publisher: Elsevier BV
Published: 2006-03
Volume: 117
Issue: 3
Pages: 549-556
ISSN: 0091-6749 (ISSN-L)
DOI: 10.1016/j.jaci.2006.01.011
OpenAlex: W2086332783
Cited by: 1,221
References: 17
Citations by year: 2026: 55 · 2025: 58 · 2024: 61 · 2023: 58 · 2022: 89 · 2021: 89 · 2020: 92 · 2019: 95 · 2018: 69 · 2017: 73 · 2016: 73 · 2015: 46 · 2014: 57 · 2013: 66 · 2012: 48
FWCI: 20.33
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Allergy and Clinical Immunology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
Keywords: Asthma Control Test, asthma control, patient-reported outcome measures, Asthma Control Questionnaire, reliability statistics, validity, responsiveness, uncontrolled asthma, lung function, FEV1, cut-off values
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Asthma, Child, Humans, Longitudinal Studies, Mass Screening, Middle Aged, Surveys and Questionnaires, Respiratory Function Tests, Severity of Illness Index, Reproducibility of Results

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Asthma Control Test: Reliability, validity, and responsiveness in patients not previously followed by asthma specialists

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