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Annual Congress of Malaysian Thoracic Society OP 8 Correlation Between GINA-defined asthma Control, Asthma Control Test and Lung Function Tests S Y Ooi, Y K Pang, C K Liam, K T Chua, C H Lee, B K Lim , N L Lai University Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia Introduction Assessment of asthma control remains contentious. Various assessment methods have been used. These include symptom assessment, lung function tests, questionnaires and laboratory investigations, e.g. exhaled nitric oxide. Global Initiative for Asthma (GINA) has recommended assessment based on symptoms and lung function tests. However, this strategy has not been validated in clinical trial. Objectives To assess the correlation between GINA-defined asthma control (G-AC) and the • Asthma Control Test (ACT) questionnaire • lung function tests (peak expiratory flow rate and spirometry) Methodology This is a prospective cross-sectional study conducted from 22 October 2010 till 10 June 2011 at the asthma clinic of University Malaya Medical Centre. Only patients seen by the specialists were recruited. A total of 70 asthmatics were recruited. Patients’ ages ranged from 13 to 82 years old (mean [SD], 58.24, [15.9]). Of these, 78.6% (55) were females and 21.4% (15) were males. Patients were categorised into well controlled, partially controlled and poorly controlled based on GINA-defined asthma control. One way-ANOVA test was used to examine the relationship G-AC and ACT, and between G-AC and lung function tests. Results 1. There was statistically significant difference between well-controlled asthma or partially controlled asthma and poorly controlled asthma in term of their ACT scores. 2. However, there was no statistical difference between well-controlled and partially controlled asthma. 3. PEFR and Spirometry tests did not show statistical difference between the 3 asthma control groups. Conclusions 1. If ACT is to be used in conjunction with other clinical assessment, it may suffice to distinguish between controlled and uncontrolled asthma status (without the category of partially controlled asthma). 2. While PEFR and spirometry may be useful to assess asthma control over a course of time, one-off point assessment may not be useful in assessing asthma control. 55
Annual Congress of Malaysian Thoracic Society Op 9 The Correlation between COPD Assessment Test, FEV1, MMRC Scores and 6MWT Harre Harren, Y K Pang, C K Liam, K T Chua, B K Lim, C H Lee, N L Lai University Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia Objectives To investigate the consistency between the COPD Assessment Test (CAT) score and the six-minute-walk test, the correlation between the CAT score and the percentage of FEV1 predicted, the correlation between the CAT score and the Modified Medical Research Council (MMRC) score for dyspnoea. Furthermore, we need to ascertain if the CAT questionnaire can be used as a quick, easy and reliable clinical tool in assessing the severity of COPD in Malaysia. Methodology This is a cross-sectional study involving consecutive patients with an established diagnosis of COPD followed up in the respiratory clinic in University Malaya Medical Centre (UMMC), conducted from March to August 2010. A total of 60 patients were recruited. The patients were assessed on the symptoms of COPD and their performance status. Simple tests such as spirometry and the six-minute-walk test were carried out on every patient. Each patient was then asked to fill up the CAT questionnaire consisting of 8 questions pertaining to their COPD symptoms. The physician was blinded to the findings of the patients’ CAT scores. These were later compared to the CAT scores, after completion of the study. Results There was good correlation between the CAT scores and the six-minute-walk test and the MMRC dyspnoea scale. However, there was hardly any association between Percentage of FEV1 predicted and the CAT score. Conclusion This study shows that the CAT is a short and simple patient-completed questionnaire for COPD with excellent measurement properties. The CAT will provide clinicians and patients with a simple, quick and reliable measure of overall COPD-related health status for the assessment and long-term follow up of patients. The content and layout of the CAT allows identification of important areas of health impairment so that the clinician can focus on them and explore further in the consultation. Thus, the CAT should improve communication between clinician and patient, giving a common understanding of the severity and impact of the patient’s disease. This enables COPD treatment to be better targeted and optimised. 56
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