Consistency of GINA criteria and childhood asthma control test on the determination of asthma control

Background: Reliable assessment of asthma control is essential for effective treatment. Although several methods are used to assess asthma control, it is still suboptimal all over the world. Childhood asthma control test (C-ACT) is a widely used complementary test in determining the level of asthma control in conjunction with GINA guidelines. Objective: To evaluate the consistency between the childhood asthma control test (C-ACT) and the Global Initiative for Asthma (GINA) guidelinebased asthma control measure in children with asthma and, if present, to investigate the reasons for any discrepancy. Methods: Patients and their caregivers filled a C-ACT and a socioeconomic status survey before the physician visit. Asthma control level was also assessed according to GINA criteria by a pediatric allergist who was blinded to C-ACT scores. Results: The mean age of the total 314 patients was 9.0 +/- 1.9 yr, ranging between 4.3 and 11.8 yr, of whom 56.1% (n = 176) were men. Regarding the study group, 54.8% of patients were controlled according to GINA, and 51.0% of patients were controlled according to C-ACT (score =20). There was inconsistency between GINA and C-ACT in 26.7% (84/314) of the study group when the patients were evaluated individually (kappa = 0.464). There was not any significant variable that could predict the consistency and inconsistency between these methods. Conclusion: Consistency between GINA and C-ACT is not as to be expected. Using only one method for determining the control level of asthma does not seem to be reliable and accurate.