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Determining pediatric asthma control in real-life: Comparison of Pediatric Asthma Control Test, Asthma Control Test, Fractional exhaled nitric oxide, Pediatric Asthma Quality of Life Questionnaire and Lung function with GINA criteria
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  • Aysegul Akan,
  • Emine Misirlioglu,
  • Ersoy Civelek,
  • Can Kocabas
Aysegul Akan
Health Sciences University, Trabzon Kanuni Research and Education Hospital

Corresponding Author:[email protected]

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Emine Misirlioglu
Health Sciences University, Ankara City Hospital
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Ersoy Civelek
Ankara Children’s Hematology Oncology Education and Research Hospital
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Can Kocabas
Hacettepe University Faculty of Medicine
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Background Guidelines as Global Initiative for Asthma(GINA) recommend disease control as the mainstay of asthma management. The performance of the tools assessing in asthma control is challenging in real-life. Methods Children and adolescents with asthma followed at a tertiary research hospital were enrolled in the study after evaluation of adherence to treatment. Asthma Control Test(ACT)/Pediatric Asthma Control Test(PACT), Pediatric Asthma Quality of Life Quesstionnaire(PAQLQ), fractional exhaled nitric oxide(FeNO) and lung function were evaluated. Patients were examined by asthma specialists blinded to the results of the tools and their control status were evaluated based on GINA. Results The median age(interquartile range,IQR) of the patients was 10.7(8.4-12.9) years, 57.9% were boys. Of 228 children, 84.2%, 9.6% and 6.1% had “well-controlled”, “partially-controlled” and “uncontrolled” asthma, respectively. The patients with “partially-controlled “ and “uncontrolled” asthma were grouped as “not well-controlled”. The cut-off levels were 22, 21 and 5.9 for PACT, ACT and PAQLQ for determining “well-controlled” asthma(p<0.001). With these cut-off values, ACT had the higher compatibility with GINA than PACT and PAQLQ(κ=0.221, 0.473 and 0.150, respectively, p<0.001). Correctly classified patients with PACT, ACT and PALQLQ based on GINA with these cut-off levels were 93(64.1%), 63(75.9%) and 139(62.9%), respectively. FeNO and lung function were unsuccessful at revealing control status according to GINA. Conclusion ACT is better than PACT at compatibility with GINA. Probably, it is because older children have a longer recall period than younger ones. It would be better to use these tools for each patient by comparing their own scores in real-life, instead of cut-off values.