An Evaluation On Reliability And Validity Of The Revised Edition Of Asthma Control Questionnaire For Chest Tightness Variant Asthma

Background:As a newfound type of variant asthma,chest tightness variant asthma(CTVA)was firstly named by domestic experts.Scales that are effective for the clinical assessment of CTVA are in need.Current scales such as Asthma Control Questionnaire(ACQ)?Asthma Control Test(ACT)?Asthma Therapy Assessment Questionnaire(ATAQ),were mainly developed for the ssessment of typical asthma,thus being some what unsuitable for CTVA.In many scales,ACQ and ACT have significant advantages in assessing asthma control,and there is no clear tendency in the choice of ACQ and ACT intermatioally.Considering that the contents of the ACQ scale are more allied to the criteria of asthma control in the Global Initiative for Asthma(GINA)guidelines,so the team developed a revised Asthma Control Questionnaire(r-ACQ)on the basis of the original ACQ scale for CTVA,in which chest tightness was the only symptom.The study aims to evaluate the clinical validity,utility and responsiveness of the revised edition of Asthma Control Questionnaire(r-ACQ)in patients with CTVA,and to provide theoretical basis for clinical application of the r-ACQ.Methods:The r-ACQ for CTVA was developed from Asthma Control Questionnaire(ACQ)scale.Patients diagnosed with CTVA were randomly enrolled from the Second Affiliated Hospital of Zhejiang University School of Medicine from May 2015 to December 2016.All participants completed the r-ACQ,the Asthma Quality of Life Questionnaire(AQLQ)and the MOS item short from health survey(SF-36)at enrollment.After one-month's treatment,participants were reevaluated by the r-ACQ and the Global Rating of Change(GRC)at follow-up visits.Results:Finally,66 patients were enrolled.All of them completed the r-ACQ and AQLQ scores during the study enrollment phase,and 43 patients completed the SF-36 scale.There was no statistical difference between the AQLQ and r-ACQ scores of the 43 patients and 66 patients.After 1 month of treatment,all patients were followed up.Among them,18 patients showed no change in asthma condition according to GRC scores,23 patients showed significant improvement,and 25 patients showed mild improvement.The correlation coefficient between the r-ACQ and AQLQ(n = 66)was-0.706(P<0.001).The r-ACQ scores were also associated with several dimensions of the SF-36,including the Role Physical(r =-0.655,P<0.001),the Social Function(r =-0.453,P ?0.002)and the Vitality(r =-0.407,P = 0.007)dimension.The Cronbach's alpha coefficient of all items in r-ACQ was 0.632.Besides,the intra-class correlation coefficient was 0.959(95%confidence interval,0.891?0.985)according to patients with no change in chest tightness(n = 18)at follow-up visits.Moreover,patients with improvements in chest tightness(n = 23)had a significant improvement in the r-ACQ scores(P<0.001).Conclusions:The r-ACQ shows excellent clinical validity,utility and responsiveness.Thus,the r-ACQ is appropriate for clinical assessment in CTVA patients.