J Korean Med Sci.  2010 Aug;25(8):1134-1139. 10.3346/jkms.2010.25.8.1134.

Customized Asthma Control Test with Reflection on Sociocultural Differences

• Yoo KH
• Jeong JW
• Yoon HJ
• Chang SI
• Moon HB
• Choi BH
• Kim YY
• Cho SH

• KMID: 1714032
• DOI: http://doi.org/10.3346/jkms.2010.25.8.1134

Abstract

We evaluated the utility and feasibility of customizing Asthma Control Test (ACT) items to generate a Korean Asthma Control Test (KACT) specific for Korean patients. We surveyed 392 asthma patients with 19 items, selected to reflect the Korean sociocultural context. Guideline ratings were integrated with the evaluations of specialists (i.e., using both guide base rating together with specialist's rating), and items with the greatest discriminating validity were identified. Stepwise regression methods were used to select items. KACT scale scores showed significant differences between the asthma control ratings generated by integrating ratings (r=0.77, P<0.001), by specialist's evaluations (r=0.54, P<0.001), or by FEV1 percent predicted (r=0.39, P<0.001). Specialist's and guideline ratings detected 56% and 48.6% of patients with well-controlled asthma, respectively. However, the integrated ratings indicated that only 34.3% of the patients in the test sample were well controlled. The overall agreement between KACT and the integrated rating ranged from 45% to 78%, depending on the cut-off points used. It is possible to formulate a valid, useful country-specific diagnostic tool for the assessment of asthma patients based on the original ACT that reflect differences in sociocultural context.

Keyword

Asthma; Control; Epidemiology; Korea; Questionnaires

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Asthma/*diagnosis
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Questionnaires
ROC Curve
Socioeconomic Factors

Figure

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  Fig. 1 Area under the Receiver operating characteristic (ROC) curve for sum scoring option (range 4 to 20).

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  Fig. 2 Area under ROC curve for sum of counts scoring option (range 0 to 4).

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