Am. J. Respir. Crit. Care Med., Volume 162, Number 4, October 2000, 1330-1334

Measuring Asthma Control
Clinic Questionnaire or Daily Diary?

ELIZABETH F. JUNIPER, PAUL M. O'BYRNE, PENELOPE J. FERRIE, DEREK R. KING, and JEREMY N. ROBERTS

Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University Faculty of Health Sciences, Hamilton; Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; and LSE Health, London School of Economics, London, United Kingdom

Daily symptom, peak expiratory flow rate (PEFR), and medication diaries are often used in clinical trials of treatments for asthma on the assumption that they provide a better estimate of clinical status than does a questionnaire completed in the clinic. We conducted a study with the aim of comparing the measurement properties of the clinic-completed Asthma Control Questionnaire with those of the Asthma Control Diary. The diary is composed of questions and response options almost identical to those of the questionnaire, but uses PEFR instead of FEV₁ as the measure of airway caliber. In an observational study, 50 adults with symptomatic asthma attended a McMaster University asthma clinic at 0, 1, 5, and 9 wk to complete the Asthma Control Questionnaire and other measures of asthma status. For 1 wk before each follow-up visit, patients completed the Asthma Control Diary every morning and evening. Concordance between the questionnaire and diary was high (intraclass correlation coefficient [ICC] = 0.87). Both reliability (ICC: questionnaire = 0.90; diary = 0.86) and responsiveness (responsiveness index: questionnaire = 1.06; diary = 0.90; p = 0.005) were better with the questionnaire than with the diary. Correlations between the two instruments and other measures of clinical asthma status were similar and close to a priori predictions. Both the Asthma Control Questionnaire and the Asthma Control Diary are valid instruments for measuring asthma control, but the questionnaire has slightly better discriminative and evaluative measurement properties than does the diary.

This article has been cited by other articles:

				L. van den Nieuwenhof, T. Schermer, M. Heins, J. Grootens, P. Eysink, B. Bottema, C. van Weel, and P. Bindels Tracing Uncontrolled Asthma in Family Practice Using a Mailed Asthma Control Questionnaire Ann. Fam. Med, January 1, 2008; 6(suppl_1): S16 - S22. [Abstract] [Full Text] [PDF]

				H. P. Sharma, E. C. Matsui, P. A. Eggleston, N. N. Hansel, J. Curtin-Brosnan, and G. B. Diette Does Current Asthma Control Predict Future Health Care Use Among Black Preschool-aged Inner-City Children? Pediatrics, November 1, 2007; 120(5): e1174 - e1181. [Abstract] [Full Text] [PDF]

				K. L. Lavoie, S. L. Bacon, S. Barone, A. Cartier, B. Ditto, and M. Labrecque What is worse for asthma control and quality of life: depressive disorders, anxiety disorders, or both? Chest, October 1, 2006; 130(4): 1039 - 1047. [Abstract] [Full Text] [PDF]

				J S Halterman, H L Yoos, H Kitzman, E Anson, K Sidora-Arcoleo, and A McMullen Symptom reporting in childhood asthma: a comparison of assessment methods Arch. Dis. Child., September 1, 2006; 91(9): 766 - 770. [Abstract] [Full Text] [PDF]

				A. M. Slats, J. K. Sont, R. H.C.J. van Klink, E. H.D. Bel, and P. J. Sterk Improvement in bronchodilation following deep inspiration after a course of high-dose oral prednisone in asthma. Chest, July 1, 2006; 130(1): 58 - 65. [Abstract] [Full Text] [PDF]

				B. P. Yawn, S. K. Brenneman, F. C. Allen-Ramey, M. D. Cabana, and L. E. Markson Assessment of Asthma Severity and Asthma Control in Children Pediatrics, July 1, 2006; 118(1): 322 - 329. [Abstract] [Full Text] [PDF]

				R Ratnawati and P S Thomas Exhaled nitric oxide in paediatric asthma Chronic Respiratory Disease, July 1, 2005; 2(3): 163 - 174. [Abstract] [PDF]

				M. Berry, B. Hargadon, A. Morgan, M. Shelley, J. Richter, D. Shaw, R. H. Green, C. Brightling, A. J. Wardlaw, and I. D. Pavord Alveolar nitric oxide in adults with asthma: evidence of distal lung inflammation in refractory asthma Eur. Respir. J., June 1, 2005; 25(6): 986 - 991. [Abstract] [Full Text] [PDF]

				J Greenhalgh, H Ford, A F Long, and K Hurst The MS Symptom and Impact Diary (MSSID): psychometric evaluation of a new instrument to measure the day to day impact of multiple sclerosis J. Neurol. Neurosurg. Psychiatry, April 1, 2004; 75(4): 577 - 582. [Abstract] [Full Text] [PDF]

				H.-W. Shin, C. M. Rose-Gottron, D. M. Cooper, R. L. Newcomb, and S. C. George Airway diffusing capacity of nitric oxide and steroid therapy in asthma J Appl Physiol, January 1, 2004; 96(1): 65 - 75. [Abstract] [Full Text] [PDF]

				M. Romagnoli, I. Vachier, P. Tarodo de la Fuente, H. Meziane, C. Chavis, J. Bousquet, P. Godard, and P. Chanez Eosinophilic inflammation in sputum of poorly controlled asthmatics Eur. Respir. J., December 1, 2002; 20(6): 1370 - 1377. [Abstract] [Full Text] [PDF]

				L.-P. Boulet, V. Boulet, and J. Milot How Should We Quantify Asthma Control?: A Proposal Chest, December 1, 2002; 122(6): 2217 - 2223. [Abstract] [Full Text] [PDF]

				R. Buhl, G. Hanf, M. Soler, G. Bensch, J. Wolfe, F. Everhard, K. Champain, H. Fox, and J. Thirlwell The anti-IgE antibody omalizumab improves asthma-related quality of life in patients with allergic asthma Eur. Respir. J., November 1, 2002; 20(5): 1088 - 1094. [Abstract] [Full Text] [PDF]

				E.D. Bateman, L.F. Frith, and G.L. Braunstein Achieving guideline-based asthma control: does the patient benefit? Eur. Respir. J., September 1, 2002; 20(3): 588 - 596. [Abstract] [Full Text] [PDF]

				M. J. TOBIN Asthma, Airway Biology, and Allergic Rhinitis in AJRCCM 2000 Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1559 - 1580. [Full Text] [PDF]

				E.D. Bateman, J. Bousquet, and G.L. Braunstein Is overall asthma control being achieved? A hypothesis-generating study Eur. Respir. J., April 1, 2001; 17(4): 589 - 595. [Abstract] [Full Text] [PDF]