الملخص الإنجليزي
Objectives: Asthma control is often difficult to measure. The aim of this study was to compare
physicians' personal clinical assessments of asthma control with the Global Initiative for Asthma (GINA) scoring.
Methods: Physicians in the adult pulmonary clinics of a tertiary hospital in Oman first documented their subjective
judgment of asthma control on 157 consecutive patients. Immediately after that and in the same proforma, they
selected the individual components from the GINA asthma control table as applicable to each patient. Results: The
same classification of asthma control was achieved by physicians' clinical judgment and GINA classification in 106
cases (67.5%). In the other 32.5% (n = 51), the degree of control by clinical judgment was one level higher than the
GINA classification. The agreement was higher for the pulmonologists (72%) as compared to non-pulmonologists
(47%; P = 0.009). Physicians classified 76 patients (48.4%) as well-controlled by clinical judgment compared to 48
(30.6%) using GINA criteria (P <0.001). Conversely, they classified 34 patients (21.7%) as uncontrolled as compared
to 57 (36.3%) by GINA criteria (P <0.001). In the 28 patients who were clinically judged as well-controlled but,
by GINA criteria, were only partially controlled, low peak expiratory flow rate (PEFR) (46.7%) and limitation of
activity (21.4%) were the most frequent parameters for downgrading the level of control. Conclusion: Using clinical
judgment, physicians overestimated the level of asthma control and underestimated the uncontrolled disease. Since
management decisions are based on the perceived level of control, this could potentially lead to under-treatment
and therefore sub-optimal asthma control.
