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Longitudinal validation of a tool for asthma self-monitoring
Flory L Nkoy1, Bryan L Stone, Bernhard A Fassl
1Primary Children's Medical Center, Division of Pediatric Inpatient Medicine, University of Utah School of Medicine, 100 North Medical Dr, Salt Lake City, UT 84113. flory.nkoy@hsc.utah.edu.
Insights
The Asthma Symptom Tracker (AST) is a reliable tool for monitoring childhood asthma. It accurately tracks symptom changes, aiding proactive medical decisions for better asthma management.
Area of Science:
- Pediatric Pulmonology
- Clinical Assessment Tools
- Asthma Management
Background:
- Asthma is a chronic respiratory condition affecting children worldwide.
- Effective monitoring tools are crucial for managing pediatric asthma.
- The Asthma Symptom Tracker (AST) was developed for weekly assessment and visual trending of asthma control.
Purpose of the Study:
- To perform longitudinal validation of the Asthma Symptom Tracker (AST) in children.
- To assess the reliability, validity, and responsiveness of the AST tool.
- To evaluate the AST's utility in monitoring asthma control over time.
Main Methods:
- A prospective cohort study involving 210 children (ages 2-18) hospitalized for asthma.
- AST assessments were completed at baseline and over 6 months post-discharge.
- The Asthma Control Questionnaire (ACQ) was used concurrently for comparison with AST.
Main Results:
- AST demonstrated moderate test-retest reliability and strong internal consistency (Cronbach's α 0.70-0.90).
- Significant correlations were found between AST and ACQ scores, confirming criterion validity (r = -0.63 to -0.80).
- AST was responsive to changes, correlating with oral corticosteroid use and acute asthma visits, indicating discriminant validity.
Conclusions:
- The Asthma Symptom Tracker (AST) is a reliable, valid, and responsive tool for pediatric asthma monitoring.
- AST facilitates ongoing assessment of asthma control in children.
- The tool supports proactive medical decision-making for improved asthma management.
Objectives:
To establish longitudinal validation of a new tool, the Asthma Symptom Tracker (AST). AST combines weekly use of the Asthma Control Test with a color-coded graph for visual trending.
Methods:
Prospective cohort study of children age 2 to 18 years admitted for asthma. Parents or children (n = 210) completed baseline AST assessments during hospitalization, then over 6 months after discharge. Concurrent with the first 5 AST assessments, the Asthma Control Questionnaire (ACQ) was administered for comparison.
Results:
Test-retest reliability (intraclass correlation) was moderate, with a small longitudinal variation of AST measurements within subjects during follow-ups. Internal consistency was strong at baseline (Cronbach's α 0.70) and during follow-ups (Cronbach's α 0.82-0.90). Criterion validity demonstrated a significant correlation between AST and ACQ scores at baseline (r = -0.80, P < .01) and during follow-ups (r = -0.64, -0.72, -0.63, and -0.69). The AST was responsive to change over time; an increased ACQ score by 1 point was associated with a decreased AST score by 2.65 points (P < .01) at baseline and 3.11 points (P < .01) during follow-ups. Discriminant validity demonstrated a strong association between decreased AST scores and increased oral corticosteroid use (odds ratio 1.13, 95% confidence interval, 1.10-1.16, P < .01) and increased unscheduled acute asthma visits (odds ratio 1.23, 95% confidence interval, 1.18-1.28, P < .01).
Conclusions:
The AST is reliable, valid, and responsive to change over time, and can facilitate ongoing monitoring of asthma control and proactive medical decision-making in children.
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