The buzz word in asthma circles today is ‘control’. We speak fairly glibly about measuring control and getting patients to achieve good asthma control. Whilst this is an excellent and admirable sentiment, what is seldom discussed is what measuring control involves (just how
reliable are our current measures of control), what control really means and finally what we can do to improve control. Some studies talk about using defined symptom-based questions to assess control, while others utilise spirometry and or biomarkers of disease activity. If one looks critically, however, at these studies and guidelines, the critical scientific tests for reliability and validity of these purported measures are sometimes not done or their interpretation misleading. This is most acute in children. I do believe that we are on the right track when we say we want our patients with asthma to be ‘well controlled’. We certainly would like them to have a normal quality of life and be free of exacerbations. Quite possibly then we should state this as our goal and not use seemingly unclear tests to mark what it is we want.