Reliability and predictive validity of the Asthma Control Test administered by telephone calls using speech recognition technology

Background: The Asthma Control Test (ACT) has been validated in a paper and pencil version but has not been validated for use by telephone. Objective: The purpose of this study was to provide validation data for the ACT administered by interactive telephone calls using speech recognition technology. Methods: The ACT was administered to patients who confirmed a diagnosis of physician-diagnosed asthma, and information regarding race/ethnicity, smoking, and asthma course was also obtained during the call. Asthma emergency department visits, hospitalizations, and oral corticosteroid and beta-agonist canister dispensings were assessed for the 12 months after the date of each patient's call. Internal consistency reliability and predictive validity were assessed. Results: Asthma Control Test scores (higher indicates better control) were completed by 2244 patients and were inversely related to black or Hispanic race/ethnicity and smoking. Reliability was 0.83. ACT scores were significantly related to emergency hospital care and oral corticosteroid and P-agonist dispensings over the period of the subsequent 6 and 12 months. After adjusting for demographic characteristics, a score <= 15 was associated significantly with an increased 12-month risk of emergency hospital care (odds ratio [OR], 2.5), oral corticosteroid dispensings (OR, 2.6) and dispensing of more than 6 beta-agonist canisters (OR, 6.8) compared with a score >= 20. Conclusion: These data support the reliability and predictive validity of the ACT administered by interactive telephone calls using speech recognition technology. Clinical implications: The ACT can be used for outreach or follow-up by means of interactive telephone calls using speech recognition technology.