Concordância entre o critério proposto pela Global Initiative for Asthma (GINA) e outros instrumentos de medida para avaliação do controle clínico da asma pediátrica

Abstract

Introduction: Asthma is the most prevalent chronic lung disease among children and adolescents and affects between 1.6% and 36.8% of this population in several countries. Objective: To verify the agreement between the evaluation criteria for the clinical control of pediatric asthma proposed by the Global Initiative for Asthma (GINA) and the measurement instruments Pediatric Asthma Control and Communication Instrument (PACCI) and the Asthma Therapy Assessment Questionnaire (ATAQ). Methods: This is an observational cross-sectional analytical study, carried out with parents/guardians of children and adolescents of both sexes, between 05 and 17 years old, with a clinical diagnosis of asthma according to the GINA. Parents/guardians completed questions related to the assessment of pediatric asthma control by GINA, PACCI, and Pediatric ATAQ. Additionally, the parents/guardians provided clinical information about the child/adolescent and sociodemographic information, using the Brazilian Economic Classification Criteria (CCEB) questionnaire from the Brazilian Association of Companies and Research (ABEP). Statistical analysis was performed using SPSS software using descriptive and inferential statistics. For analysis purposes, the GINA classification of control was categorized into partially controlled/controlled and uncontrolled. The degree of agreement between the control classification was investigated using Cohen's Kappa test (κ). Results: After performing the Cohen's Kappa test, it was found that the ATAQ instrument showed moderate agreement (k = 0.58; 95%CI 0.42-0.74), the PACCI, through the sum of the scores, showed substantial agreement (k = 0.61; 95%CI 0.44-0.78) and the PACCI, through the problem index, presented a fair agreement with the GINA criteria (k = 0.40; 95%CI 0.22 -0.58). Conclusion: The ATAQ and PACCI instruments, through the measures obtained by the sum of the scores, were the instruments that showed the greatest agreement, with moderate agreement and substantial agreement, respectively, with the pediatric asthma assessment criteria proposed by the GINA.