Measuring asthma control: a comparison of three classification systems

P. M. O'Byrne, H. K. Reddel, Göran Eriksson, O. Ostlund, S. Peterson, M. R. Sears, C. Jenkins, M. Humbert, R. Buhl, T. W. Harrison, S. Quirce, E. D. Bateman

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There are various ways to classify asthma control; however, no classification is universally accepted. This retrospective analysis compared asthma control as assessed by the Asthma Control Questionnaire (5-item version; ACQ-5), Global Initiative for Asthma (GINA) or Gaining Optimal Asthma Control (GOAL) study criteria. Pooled data at the final study week (n=8,188) from three budesonide/formoterol maintenance and reliever therapy studies which measured ACQ-5 were stratified according to GINA or GOAL criteria and ACQ-5 score distribution. The percentages of patients with a controlled/partly controlled week (GINA), totally/well-controlled week (GOAL) and range of ACQ-5 cut-off points were compared. Patients with GINA controlled, partly controlled and uncontrolled asthma had mean ACQ-5 scores of 0.43, 0.75 and 1.62, respectively. Patients with GOAL totally controlled, well-controlled and uncontrolled asthma had ACQ-5 scores of 0.39, 0.78 and 1.63. The kappa measure of agreement was 0.80 for GINA and GOAL criteria, and 0.63 for GINA controlled/partly controlled and ACQ-5 <1.00. ACQ-5 detected clinically important improvements in 49% of patients who, according to GINA criteria, remained uncontrolled at the end of the study. Asthma control measured by GINA or GOAL criteria provides similar results. GINA Controlled/Partly Controlled and GOAL Totally Controlled/Well-Controlled correspond to ACQ-5 <1.00. The ACQ-5 is more responsive to change in a clinical trial setting than a categorical scale.
Original languageEnglish
Pages (from-to)269-276
JournalEuropean Respiratory Journal
Issue number2
Publication statusPublished - 2010

Subject classification (UKÄ)

  • Respiratory Medicine and Allergy


  • Control
  • Gaining Optimal Asthma
  • Asthma control
  • Asthma Control Questionnaire
  • Global Initiative for Asthma


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