Validation of a guideline-based composite outcome assessment tool for asthma control

Respiratory Research

Table 1 Definitions of well controlled (WC) and totally controlled (TC) asthma based on Global Initiative for Asthma (GINA)/National Institutes of Health (NIH) guideline aims of treatment [3, 8]

	Goals of GINA/NIH	Totally controlled	Well controlled
		Each week all of:	Each week two or more of:
Daytime symptoms	Minimal (ideally no)	None	≤ 2 days symptom score > 1
Rescue β ₂ -agonist use	Minimal (ideally no)	None	Use on ≤ 2 days and ≤ 4 occasions per week
Morning peak expiratory flow	Near normal	≥ 80% predicted every day	≥ 80% predicted every day
			All of:
Night-time awakening	Minimal (ideally no)	None	None
Exacerbations	Minimal (infrequent)	None	None
Emergency visits	No	None	None
Treatment-related adverse events	Minimal	None enforcing change in asthma therapy	None enforcing change in asthma therapy

TC and WC asthma were defined as achievement of all of the specified criteria for that week. Asthma control was achieved if the patient recorded 7 out of 8 controlled weeks prior to each clinic visit. Baseline control was assessed over a 4-week period. Predicted peak expiratory flow (PEF) was calculated based on the ECSC standards for patients 18 years and older and on the Polgar standards for patients 12–17 years old.
Symptom score: 1 was defined as 'symptoms for one short period during the day'. Overall scale: 0 (none) – 5 (severe).
Exacerbations were defined as deterioration in asthma requiring treatment with an oral corticosteroid or an emergency department visit or hospitalisation.

ISSN: 1465-993X