OpiCalc

989 Clinical Tools

AAS (Angioedema Activity Score)Asthma Control Test (ACT)FeNO Interpretation Mueller Grading (Venom Allergy)Total Nasal Symptom Score (TNSS)UAS7 (Urticaria Activity Score)

Asthma Control Test (ACT)

ACT (Asthma Control Test): Assesses respiratory control for patients 12+.

Q1: How much of the time did asthma keep you from getting as much done at work, school or at home?

Q2: During the past 4 weeks, how often have you had shortness of breath?

Q3: How often did asthma symptoms wake you up at night or earlier than usual?

Q4: How often have you used your rescue inhaler or nebulizer medication?

Q5: How would you rate your asthma control during the past 4 weeks?

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Standardized assessment of asthma control in patients ≥ 12 years old.

Routine follow-up in primary care or specialist asthma clinics (every 1–6 months).

To guide step-up or step-down management of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA).

To identify patients at high risk of acute asthma exacerbations.

Population

The standard ACT is validated for ages 12 and older. For children aged 4–11, the Childhood Asthma Control Test (C-ACT) should be utilized.

Section 2

Formula & Logic

Core Assessment (Past 4 Weeks)

Frequency of shortness of breath.

Frequency of nighttime awakenings due to asthma symptoms.

Frequency of rescue inhaler use (SABA).

Self-perception of asthma control.

Activity limitation (interference with work/school).

Scoring Logic

Response	Frequency Description	Points
None/All the time	Numerical scale per question	1–5
Maximum Score	Total points from 5 questions	25

Section 3

Pearls/Pitfalls

The "Well-Controlled" Threshold

A score of 20 or higher indicates well-controlled asthma. However, a score of 25 (perfect control) should be the clinical goal for most patients.

Predictive Value

ACT scores correlate inversely with airway inflammation (FeNO) and hyper-responsiveness.

A change of 3 points is considered the Minimal Clinically Important Difference (MCID).

Low ACT scores are an independent risk factor for future near-fatal asthma events.

Section 4

Next Steps

Management Action (GINA 2023)

Score 20–25: Controlled. Maintain current therapy. Consider step-down if stable for >3 months.

Score 16–19: Partly Controlled. Review inhaler technique, adherence, and triggers. Consider step-up therapy.

Score ≤ 15: Uncontrolled. Urgent review required. Step-up therapy (e.g., increase ICS dose or add LABA/LAMA/Biologic).

Section 5

Evidence Appraisal

Pivotal Studies

Development of the asthma control test: a survey for assessing asthma control

Nathan RA et al. • J Allergy Clin Immunol. 2004;113(1):59-65.

View Source

The validity of the Asthma Control Test in accurately identifying patients with poorly controlled asthma

Schatz M et al. • Chest. 2006;130(3):812-8.

View Source

Section 6

Literature

Development

The ACT was developed by QualityMetric Incorporated and a panel of asthma specialists to simplify the assessment of control compared to the much longer ACQ (Asthma Control Questionnaire).

Last Comprehensive Review: 2026

Related Allergy & Immunology Tools

AAS

FeNO Interpretation

Mueller Grading

Total Nasal Symptom Score

UAS7

Have feedback about this calculator?Let us know.

Asthma Control Test (ACT)

ACT (Asthma Control Test): Assesses respiratory control for patients 12+.

Q1: How much of the time did asthma keep you from getting as much done at work, school or at home?

Q2: During the past 4 weeks, how often have you had shortness of breath?

Q3: How often did asthma symptoms wake you up at night or earlier than usual?

Q4: How often have you used your rescue inhaler or nebulizer medication?

Q5: How would you rate your asthma control during the past 4 weeks?

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Standardized assessment of asthma control in patients ≥ 12 years old.

Routine follow-up in primary care or specialist asthma clinics (every 1–6 months).

To guide step-up or step-down management of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA).

To identify patients at high risk of acute asthma exacerbations.

Population

The standard ACT is validated for ages 12 and older. For children aged 4–11, the Childhood Asthma Control Test (C-ACT) should be utilized.

Section 2

Formula & Logic

Core Assessment (Past 4 Weeks)

Frequency of shortness of breath.

Frequency of nighttime awakenings due to asthma symptoms.

Frequency of rescue inhaler use (SABA).

Self-perception of asthma control.

Activity limitation (interference with work/school).

Scoring Logic

Response	Frequency Description	Points
None/All the time	Numerical scale per question	1–5
Maximum Score	Total points from 5 questions	25

Section 3

Pearls/Pitfalls

The "Well-Controlled" Threshold

A score of 20 or higher indicates well-controlled asthma. However, a score of 25 (perfect control) should be the clinical goal for most patients.

Predictive Value

ACT scores correlate inversely with airway inflammation (FeNO) and hyper-responsiveness.

A change of 3 points is considered the Minimal Clinically Important Difference (MCID).

Low ACT scores are an independent risk factor for future near-fatal asthma events.

Section 4

Next Steps

Management Action (GINA 2023)

Score 20–25: Controlled. Maintain current therapy. Consider step-down if stable for >3 months.

Score 16–19: Partly Controlled. Review inhaler technique, adherence, and triggers. Consider step-up therapy.

Score ≤ 15: Uncontrolled. Urgent review required. Step-up therapy (e.g., increase ICS dose or add LABA/LAMA/Biologic).

Section 5

Evidence Appraisal

Pivotal Studies

Development of the asthma control test: a survey for assessing asthma control

Nathan RA et al. • J Allergy Clin Immunol. 2004;113(1):59-65.

View Source

The validity of the Asthma Control Test in accurately identifying patients with poorly controlled asthma

Schatz M et al. • Chest. 2006;130(3):812-8.

View Source

Section 6

Literature

Development

The ACT was developed by QualityMetric Incorporated and a panel of asthma specialists to simplify the assessment of control compared to the much longer ACQ (Asthma Control Questionnaire).

Last Comprehensive Review: 2026

Related Allergy & Immunology Tools

AAS

FeNO Interpretation

Mueller Grading

Total Nasal Symptom Score

UAS7

Have feedback about this calculator?Let us know.