Laura Montalbano1,2, Giovanna Cilluffo1,3, Manuel Gentile4, Giuliana Ferrante5, Velia Malizia1, Fabio Cibella1, Giovanni Viegi1,6, Giovanni Passalacqua7 and Stefania La Grutta1,*
Abstract
Background: Pediatric Asthma Quality of Life Questionnaire (PAQLQ) provides detailed information on QoL in asthmatic children whereas childhood Asthma Control Test (C-ACT) is the most validated instrument for asthma control. No study assessed the relationship between C-ACT and QoL in children by means of those instruments. Aim of the study was to determine whether a QoL estimation is possible using the C-ACT questionnaire in asthmatic children.
Methods: Medical history, spirometry, C-ACT and PAQLQ were assessed in 144 (60% male) outpatient asthmatic children from September 2011 to November 2014. A Generalized linear model (GLM) for prediction of PAQLQ was obtained through a stepwise procedure starting from a full model with all C-ACT item and predictive nomograms was created.
Results: 55 (38%) Well Controlled asthma (WC), 37 (26%) Partially Controlled (PC), and 52 (36%) Uncontrolled (UA) patients were enrolled. Persistent Asthmatics (PA) were significantly more uncontrolled (p<0.0001). A significant reduction in FEV1, FEV1/FVC, FEF25-75 (p=0.005, p<0.0001, p<0.001, respectively) was found in WC vs UA. Through a stepwise process, a reduced model showed a positive relationship between the PAQLQ and the four items of C-ACT. The regression equations for predicted PAQLQ were ln(PAQLQ)=0.05*C-ACT2+0.03*C-ACT3+0.04*C-ACT6+0.03*C-ACT7. Thus a nomogram was constructed.
Conclusion : The designed nomogram provides a highly predictive assessment of QoL in individual patients, facilitating a more comprehensive assessment of asthmatic children in usual clinical care.