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Preliminary Reports |

How Should We Quantify Asthma Control?*: A Proposal

Louis-Philippe Boulet, MD, FCCP; Véronique Boulet; Joanne Milot, BSc
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*From the Centre de recherche de l’Hôpital Laval, Institut de cardiologie et de pneumologie de l’Université Laval, Sainte-Foy (Québec), Canada.

Correspondence to: Louis-Philippe Boulet, MD, FCCP, Institut de cardiologie et de pneumologie de l’Université Laval, 2725, chemin Sainte-Foy, Sainte-Foy, Québec, Canada; e-mail: lpboulet@med.ulaval.ca



Chest. 2002;122(6):2217-2223. doi:10.1378/chest.122.6.2217
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Background: Current asthma guidelines suggest a series of criteria to assess if asthma is controlled. However, there is a need to develop a simple and practical method to quantify the degree of such control, both in clinical practice and research.

Study objectives: This report describes a new method to quantify asthma control based on a percentage score. It also aims at comparing the percentage scores obtained with patient’s self-evaluation of asthma control and a current validated Mini Asthma Quality of Life (MAQOL) questionnaire.

Setting and subjects: Forty-two subjects (25 female and 17 male patients) with asthma of different severity recruited from a tertiary center asthma clinic.

Methods: The asthma scoring method provided a percentage control for symptoms, baseline expiratory flows and, an optional parameter, for airway inflammation assessed from induced-sputum eosinophil count. These control parameters were compared to an overall assessment of asthma control by the patient (also on a 100% scale) and the score obtained from a validated MAQOL questionnaire.

Results: Mean ± SEM scores for symptoms, expiratory flows, and airway eosinophilia (last 2 weeks) were 87.8 ± 1.4%, 88.6 ± 1.8%, and 66.2 ± 3.9%, respectively. No significant correlation was found between these three parameters (p > 0.05). The mean global asthma control score and the score estimated by the patient were 80.9 ± 1.5% and 91.7 ± 1.5%, respectively (not significantly different). There was a significant correlation between asthma control score (percentage) and percentage symptom score (p < 0.001), while it almost achieved significance for FEV1 (p = 0.05). Only symptom scores correlated with the MAQOL questionnaire.

Conclusions: We developed a simple easy-to-use asthma control scoring system based on a percentage of optimal control. The percentage symptom score but not the global control score of this new method correlated with patient’s global assessment of asthma control. This could be a simple tool that is potentially useful both for the clinician and for research purposes, to quantify global or specific aspects of asthma control.

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asthma

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