Jagdish Prasad Goyal¹, Saurabh Agarwal ¹, Prawin Kumar¹
1- Department of Peditrics, AIIMS, Jodhpur, India
Abstract Body
Introduction: The Asthma Control Questionnaire (ACQ) assesses asthma control over the preceding week. The original 7-item ACQ includes reliever use and lung function, which the Global Initiative for Asthma (GINA) does not recommend for symptom control assessment,leading to shorter versions (ACQ-5 and ACQ-6). Data on their performance in children are limited.
Objective: To compare the diagnostic performance of ACQ-5, ACQ-6, and ACQ-7 against the GINA symptom control tool for identifying well-controlled asthma in children.
Methods: In this cross-sectional study , children aged 7–16 years with asthma and ≥3 months of follow-up were evaluated in a pediatric chest clinic. Demographic and clinical data, GINA treatment step, spirometry , and asthma control scores were recorded. ACQ-5, ACQ-6a, ACQ- 6b, and ACQ-7 were compared with GINA symptom control criteria. Diagnostic accuracy was assessed using conventional (0.75) and ROC-derived cut-offs. Agreement, interobserver reliability (κ), test–retest reliability (intraclass correlation coefficient), and Bland–Altman analyses were performed.
Results: Median ACQ scores were significantly lower in well-controlled asthma than in poorly controlled asthma across all versions. At a cut-off of 0.75, ACQ-6b showed the highest sensitivity and negative predictive value, while ACQ-6a had the highest specificity . Areas under the ROC curves were similar across all ACQ versions. ACQ-7 demonstrated the highest interobserver reliability . Test–retest reliability was excellent for shortened versions, and Bland–Altman analysis showed good agreement with ACQ-7 .
Conclusions: Shortened ACQ versions perform comparably to ACQ-7 and the GINA symptom control tool for identifying well-controlled asthma in children.