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Longitudinal validation of the Test for Respiratory and Asthma Control in Kids in pediatric practices
Bradley Chipps1, Robert S Zeiger, Kevin Murphy
1Capital Allergy and Respiratory Disease Center, 5609 J St, Suite C, Sacramento, CA 95819, USA. bchipps@capitalallergy.com
Insights
The Test for Respiratory and Asthma Control in Kids (TRACK) accurately tracks changes in asthma control for young children treated by pediatricians. This tool shows responsiveness to clinical status shifts and therapy adjustments.
Area of Science:
- Pediatric Pulmonology
- Clinical Assessment Tools
- Asthma Management
Background:
- The Test for Respiratory and Asthma Control in Kids (TRACK) was initially validated in specialist settings.
- Monitoring respiratory and asthma control in preschool-aged children is crucial for effective management.
- Pediatrician-managed care settings require validated tools for assessing pediatric asthma control.
Purpose of the Study:
- To evaluate the responsiveness of the TRACK tool to changes in respiratory and asthma control status over time.
- To further assess the reliability and validity of the TRACK tool in a primary pediatric care setting.
- To confirm TRACK's utility for monitoring preschool children with asthma symptoms.
Main Methods:
- A longitudinal study involved 438 children younger than 5 years with asthma symptoms.
- Caregivers completed the TRACK tool at two visits 4-6 weeks apart.
- Physicians, blinded to TRACK scores, completed a control survey and indicated therapy changes.
Main Results:
- TRACK scores changed significantly in the expected direction based on clinical improvement, stability, or worsening (P < .001).
- Lower TRACK scores correlated with poorer asthma control, need for increased therapy, and higher symptom frequency.
- Significant differences in mean TRACK scores were observed across patient subgroups (P < .001).
Conclusions:
- The study confirms the responsiveness of the TRACK tool to changes in respiratory control status in preschool children with asthma.
- This research extends the evidence for TRACK's validity and reliability in a broader pediatric population.
- TRACK is a valuable tool for monitoring asthma control in young children managed by pediatricians.
Objective:
The 5-item, caregiver-completed Test for Respiratory and Asthma Control in Kids (TRACK) was developed and validated primarily in asthma-specialist practices to monitor respiratory control in preschool-aged children. This longitudinal study in children treated by pediatricians evaluated the responsiveness of TRACK to changes in respiratory- and asthma-control status over time and further assessed TRACK's reliability and validity.
Patients And Methods:
Caregivers of children younger than 5 years with symptoms consistent with asthma within the past year (N = 438) completed TRACK at 2 clinic visits separated by 4 to 6 weeks. Physicians were blinded to caregiver assessment, completed a guidelines-based respiratory-control survey at both visits, and were asked whether the visit resulted in a change in therapy. Responsiveness of TRACK to change in respiratory-control status over time was evaluated; reliability and discriminant validity were assessed.
Results:
Mean changes in TRACK scores from the initial to follow-up visits differed in the expected direction in subsets of children whose clinical status improved, remained unchanged, or worsened based on physicians' and caregivers' assessments (P < .001). Mean TRACK scores also differed significantly (P < .001) across patient subsets, with lower scores (indicating poorer control) in children classified as very poorly controlled, in those who required a step-up in therapy, and in those who had 4 or more episodes or attacks of wheezing, coughing, or shortness of breath per week in the past 3 months.
Conclusions:
The present study extends the validity and reliability of TRACK by demonstrating its responsiveness to change in respiratory-control status over time in preschool-aged children with symptoms consistent with asthma.
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