Selection of Representative Questionnaire Items from the Asthma Control Test

Abstract

Asthma is a disease characterized by the appearance of transient or persistent symptoms in response to allergens, viral upper respiratory infections, and cold air. Asthma treatment aims to control, rather than cure, and digital systems can be useful in this regard. However, conventional assessment methods for asthma control are not suitable for digital healthcare. Therefore, we aimed to select representative questionnaire items suitable for digitally assessing the asthma control status. We analyzed the Asthma Control Test (ACT) and selected representative items. Throughout the year 2020, ACT results (2019 in total) collected from patients (>18 years old) with a principal diagnosis of asthma were analyzed. Individual questionnaire items were tested using Pearson’s correlation and receiver operating characteristic curves. Of the five questionnaire items, Q1, Q2, Q3, and Q5 yielded significant findings. Among these questionnaires, Q2 was the most descriptive and correlated questionnaire. Q5 was also significant but it was excluded since it was unable to apply to the digital health care system for asthma assessment method. The remaining three questionnaire items were selected and their sensitivity and specificity were assessed. Eight methods were analyzed, and the sum of scores of Q1–Q3 had the highest sensitivity and specificity (97% and 91%, respectively). The results suggested that, instead of the full items of ACT, the sum of Q1–Q3 can be used to assess the asthma control status. These findings will serve as the foundation for developing digital asthma control assessment tools.