Somashekar, et al. [1] published their study on evaluation of
asthma control in children Using Childhood-Asthma Control Test (C-ACT)
and Asthma Therapy Assessment Questionnaire (ATAQ) in a recent issue of
Indian Pediatrics [1]. I seek following clarifications:
1. Spirometry is an important objective measure of
airflow limitation, but valid measurements depend on patient’s ability
to perform full, forceful and prolonged expiratory efforts, which are
generally feasible in children aged >6 years. At ages <6 years, its
valid measurement is exception rather than rule, and highlights
effort-dependence of valid spirometric testing [2].
Peak expiratory flow rate monitoring devices are less
sensitive and less reliable as compared to spirometry. If used over a
period of several weeks, they enable to find out personal best and
diurnal variation.
2. Study was done over a period of 6 months (It
should be from April 2014 to September 2014).
3. Although authors’ acknowledge language barrier
being one of the limitations of the study, I would like to know if C-ACT
Questionnaire was translated in Hindi/Kannada or English version was
used? Getting it translated and answering in regional/ local language
would have better validated results.
4. Whether clinicians taking patient history and
performing clinical evaluation to assess asthma control were blinded to
patient responses on the questionnaires to reduce the subjective nature
of the questionnaire [3]?
References
1. Somashekar AR, Ramakrishnan KG. Evaluation of
asthma control in children using Childhood – Asthma Control Test (C-ACT)
and Asthma Therapy Assessment Questionnaire (ATAQ). Indian
Pediatr. 2017;54:746-8.
2. Liu AH, Covar RA, Spahn JD, Sicherer SH. Childhood
Asthma. In: Kliegman RM, Stanton BF, St Geme III JW, Schor NF,
editors. Nelson Textbook of Pediatrics. 1st South Asia ed. New Delhi:
Elsevier; 2016. p. 1095-1115.
3. Andrew HL, Robert Z, Christine S, Todd M, Nancy O, Somali B, et
al. Development and cross-sectional validation of the Childhood
Asthma Control Test. J Allergy Clin Immunol. 2007;119:817-25.