TABLE 2

Objective Measures of Asthma Control

SpirometryMeasured by ATS/ERS guidelines and using NHANES-3 normative values. Serial measures should be performed at the same time each day, if possible (Indicate whether bronchodilator was withheld before test.)
Standardized methodology and equipment (ATS/ERS guidelines)
Performed in a clinic/laboratory setting under the supervision of a qualified technician
Can be performed by children >5 y (in general) under guidance of trained personnel
Portable and handheld devices available for use in the field/home settings
FEV1 report:
 Percent predicted values (at baseline and at any other time point, if applicable)
 Changes over the course of evaluation:
  Percent change from baseline in the absolute value
  Absolute change from baseline (in milliliters)
  Change from baseline in the percent predicted value
FEV1/FVC report:
 Ratio of absolute values (at baseline and at any other time point, if applicable)
 Changes over the course of evaluation:
  Absolute change from baseline in the value of the ratio
  Change from baseline in the percent predicted value
Bronchodilator reversibility (prebronchodilator and postbronchodilator spirometry)1. Withhold bronchodilator before the measure (12–24 h for long-acting β-2-agonists or anticholinergics; 4–6 h for short-acting β-agonists)
2. Administer 4 separate puffs of albuterol (90 mg of albuterol base/puff) with spacer at 30-s intervals between puffs, followed by spirometry after 15 min
Report:
 Prebronchodilator and postbronchodilator FEV1 (expressed as percent predicted)
 Percent change from prebronchodilator to postbronchodilator in the absolute value of FEV1
 Absolute change in FEV1 from prebronchodilator to postbronchodilator (in milliliters)
PEFPEF is a measure of maximum instantaneous expiratory
Can be self-administered on a daily basis and results recorded manually or electronically to obtain day-to-day or within-day variability
Percent predicted values (NHANES-3 normative values)
When measured with a peak flowmeter, PEF is usually expressed in units of L/min; in contrast, when PEF is measured with spirometry systems, it is usually expressed in units of liters/second
Percent change from baseline in the absolute values over the course of evaluation
Absolute change from baseline over the course of the evaluation (in liters/minute)
Variability (diurnal amplitude as a percentage of the day’s mean)
  • Adapted from Tepper et al.24