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Development and validation of a questionnaire to assess asthma control in pediatrics
E G Pérez-Yarza1, X Badía, C Badiola
1Department of Pediatrics, Division of Respiratory Medicine, Hospital Donostia, San Sebastián, Spain.
Insights
The new Asthma Control in Children (CAN) questionnaire effectively assesses asthma control in pediatric patients. Its validated versions for carers and children demonstrate acceptable sensitivity and specificity for research and clinical use.
Area of Science:
- Pediatric Pulmonology
- Clinical Assessment Tools
- Asthma Management
Background:
- Asthma control assessment in children is crucial for effective management.
- Existing tools may have limitations in capturing comprehensive control levels.
- Development of a validated questionnaire is needed for pediatric asthma.
Purpose of the Study:
- To develop and validate the Asthma Control in Children (CAN) questionnaire.
- To create versions for both child and carer perspectives.
- To establish the screening accuracy and utility of the CAN questionnaire.
Main Methods:
- A prospective, multicenter observational study involving 414 children with asthma.
- Development of two CAN questionnaire versions: one for carers and one for children (aged 9-14).
- Validation against clinician ratings of asthma control, assessing sensitivity, specificity, PPV, and NPV.
Main Results:
- The CAN questionnaire demonstrated acceptable screening accuracy.
- The patient version showed 76.3% sensitivity and 62.9% specificity at a cut-off score of 8.
- The carer version showed 73% sensitivity and 69.7% specificity at a cut-off score of 8.
Conclusions:
- The CAN questionnaire is a valid and reliable tool for assessing asthma control in children.
- Its screening accuracy supports its use in both clinical practice and research settings.
- The CAN questionnaire provides an acceptable measure for evaluating pediatric asthma control levels.
Objective:
To develop and validate a questionnaire to assess asthma control in children (CAN).
Design:
Two versions of the CAN (for carers and children) were developed. Both versions were validated in an observational, prospective, multicenter study performed in 38 hospital outpatient clinics throughout Spain. Four hundred fifteen patients and their carers agreed to participate. Of these, 414 patients under 14 years old with frequent episodic or persistent (moderate to severe) asthma completed the questionnaire on 3 occasions (baseline, week 2, and week 12). For patients aged 2-8 the questionnaire was only completed by the carers, but for patients aged 9-14 the questionnaire was completed by the carers and the children. Clinician ratings of asthma control were used as a gold standard to assess the sensitivity, specificity, PPV and NPV of the new measure.
Results:
Evaluable responses were obtained from 215 carers for children aged 2-8 years and 199 children aged 9-14 years, and their parents. Using a questionnaire total score cut-off of 8 the patient version had a sensitivity of 76.3% and a specificity of 62.9%. For carer version these values were 73% and 69.7%, respectively. A cut point of 8 was selected to maximize the screening accuracy of the CAN questionnaire. Effect sizes in patients with clinician-rated improvements in asthma control were 0.33 and 0.57 for the carer and child versions, respectively.
Conclusions:
The screening accuracy and validity of the CAN questionnaire make it suitable for use in research and clinical practice. The sensitivity and specificity were close to 70%, which is acceptable for the study objective: obtain a tool to measure the level of asthma control.
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