Agreement of a child's respiratory symptom diary with parental reports and peak expiratory flow

Area of Science:

• Pediatric Pulmonology
• Clinical Research Methodology
• Respiratory Health Monitoring

Background:

• Accurate monitoring of pediatric respiratory symptoms is crucial for effective asthma and lower respiratory illness management.
• Parental reports are commonly used, but child self-reporting offers a potentially more direct perspective.
• Validating child-completed tools against established measures like parental reports and lung function is essential.

Purpose of the Study:

• To evaluate the agreement of a child-completed daily symptom diary with parental symptom reports.
• To assess the concordance of the child diary with objective lung function measurements (peak expiratory flow).
• To compare the performance of the child diary against a parent-completed diary.

Main Methods:

• A text- and symbol-based daily diary was developed for children aged 6-12 years.
• 101 children with a history of lower respiratory symptoms or asthma were enrolled.
• Agreement was assessed against parent-reported symptoms and peak expiratory flow (PEF) measurements over 5 weeks using % agreement and kappa statistics.

Main Results:

• Simple agreement between child-reported symptoms, parent-reported symptoms, and PEF variability was moderate to high.
• Kappa statistic indicated fair to moderate agreement between child and parent symptom reports.
• Agreement between both child- and parent-reported symptoms and lung function measurements was poor.

Conclusions:

• Child and parent reports on daily respiratory symptoms show fair to moderate agreement.
• The child symptom diary demonstrated poor agreement with lung function measurements.
• The child diary's agreement with lung function was comparable to that of the parent-completed diary.