The challenge of asthma control grading in clinical practice

Asthma is a chronic disease for which control is considered the management goal. However, the different methods to measure asthma control, including the Global Initiative for Asthma (GINA) criteria and Asthma Control Test (ACT), can produce conflicting results. This nationwide pediatric study compared both methods in 465 enrolled children (322 males, mean age 11.2 years). Lung function and symptom perception were also evaluated. The results showed fair concordance (k = 0.253) between GINA grading and childhood-ACT (C-ACT). Multivariate analysis revealed an association between the parents' perception of asthma and uncontrolled asthma (odds ratio [OR] = 1.52). These findings highlight the persisting puzzle of asthma control grading in primary care, which could confuse doctors. Therefore, asthma control assessment deserves adequate attention and requires substantial expertise in clinical practice.