Asthma Center

Asthma Control Test Scores for Asthma Center Patients

Asthma control can be formally assessed by using validated instruments, including the Asthma Control Test™ (ACT). The ACT includes 5 questions that evaluate daytime symptoms, nighttime symptoms, reliance on as-needed “rescue” medication, the effect of asthma on everyday functioning, and patient assessment of control, with each of these 5 responses scored on a 1 to 5 scale. Higher scores reflect improved asthma control, a major objective of asthma management.

The ACT has been routinely used at Cleveland Clinic’s Asthma Center for more than a decade. All asthma patients are asked to complete the ACT when seen at initial and follow-up visits.

The 2022 data are reported in the context of a quality measure. The American Academy of Allergy, Asthma, and Immunology Qualified Clinical Data Registry (QCDR), ¹⁻² which has been approved by Centers for Medicare and Medicaid Services, qualifies as a reporting tool for the Merit-based Incentive Payment System (MIPS).² Poor asthma control is measured by the ACT and indicated by an ACT score < 20, and an increase of 3 has been shown to be the minimal important difference for the ACT.³


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Proportion of Asthma Patients With Well-Controlled Asthma Improved Between 2021 and 2022* (N = 2494)

2021 – 2022

ACT = Asthma Control Test

*Locations include Cleveland Clinic main campus as well as other Cleveland Clinic Respiratory Institute locations in Ohio.

The chart displays a cohort of 2494 patients with asthma and ACT data available who were cared for in the Asthma Center in both 2021 and 2022. The proportion of all patients managed by the Respiratory Institute with controlled asthma improved during that time interval.

These outcomes data demonstrate that with comprehensive evaluation and multidisciplinary management, improved asthma control is possible. Rigorous monitoring and adjustments of therapies are needed as patients improve or require alternative advanced therapies available.⁴


  1. American Academy of Allergy, Asthma, and Immunology. The AAAAI QCDR., accessed June 10, 2022.
  2. Dinakar C, Lang DM. Quality measures in allergy, asthma, and immunology. Ann Allergy Asthma Immunol. 2015 Jun;114(6):435-439.
  3. Schatz M, Kosinski M, Yarlas AS, Hanlon J, Watson ME, Jhingran P. The minimally important difference of the Asthma Control Test. J Allergy Clin Immunol. 2009 Oct;124(4):719-723.
  4. Williams SA, Wagner S, Kannan H, Bolge SC. The association between asthma control and health care utilization, work productivity loss and health-related quality of life. J Occup Environ Med. 2009 Jul;51(7):780-785.