European Respiratory Society


Several tools are useful in detecting uncontrolled asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting uncontrolled asthma in children.

145 children with asthma filled in a web-based daily diary card for 4 weeks on symptoms, use of rescue medication and limitations of activities, followed by either the C-ACT or ACT. For predicting uncontrolled asthma, score cut-off points of 19 were used for C-ACT and ACT.

According to GINA guidelines, asthma was uncontrolled in 71 (51%) children and completely controlled in 19 (14%) children. The area under the curve in the receiver operating characteristic curves for C-ACT and ACT versus GINA guidelines were 0.89 and 0.92, respectively. Cut-off points of 19 for C-ACT and ACT resulted in a sensitivity of 33% and 66% in predicting uncontrolled asthma, respectively.

C-ACT and ACT correlate well with GINA criteria in predicting uncontrolled asthma, but commonly used cut-off points for C-ACT and ACT seem to underestimate the proportion of children with uncontrolled asthma as defined by GINA.


  • Support Statement

    A.A.P.H. Vaessen-Verberne received an unrestricted research grant from GlaxoSmithKline Pharmaceuticals and Consumer Healthcare (Zeist, the Netherlands) for developing web-based versions of C-ACT and ACT.

  • Statement of Interest

    Statements of interest for H.J.L. Brackel and A.A.P.H. Vaessen-Verberne can be found at

  • Received November 8, 2010.
  • Accepted January 25, 2011.
View Full Text