• Ryuji Sato, Katsuyuki Tomita, Hiroyuki Sano, Hideo Ichihashi, Shigeyoshi Yamagata, Akiko Sano, Toshiyuki Yamagata, Takayuki Miyara, Takashi Iwanaga, Masato Muraki, and Yuji Tohda.
• Department of Respiratory Medicine and Allergology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
• J Asthma. 2009 Sep 1;46(7):677-82.

BackgroundVarious factors have been reported to be useful for predicting future exacerbations.ObjectiveThis study was intended to determine a usefulness of a combination of a patient-based questionnaire, such as the Asthma Control Test (ACT) score with objective assessments, such as forced expiratory volume in 1 second (FEV(1)) and/or exhaled nitric oxide (FE(NO)), for predicting future exacerbations in adult asthmatics.MethodsWe therefore enrolled 78 subjects with mild to moderate asthma, who were clinically stable for 3 months who all had been regularly receiving inhaled steroid treatment. All subjects underwent a routine assessment of asthma control including the ACT score, spirometry, and FE(NO), and then were followed up until a severe exacerbation occurred. The predictors of an increased risk of severe exacerbation were identified and validated using decision trees based on a classification and regression tree (CART) analysis. The properties of the developed models were the evaluated with the area under the ROC curve (AUC) (95% confidence interval [CI]).ResultsThe CART analysis automatically selected the variables and cut-off points, the ACT score ConclusionThese results demonstrated that combining the ACT score and percentage of predicted FEV(1), but not FE(NO,) can sufficiently stratify the risk for future exacerbations within one year.

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