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Test for Respiratory and Asthma Control in Kids (TRACK): validation of the Portuguese version
Gustavo F Wandalsen1, Renata G Dias1, Herberto J Chong-Neto2
11Federal University of São Paulo (UNIFESP), Rua dos Otonis 725, São Paulo, SP 04025-002 Brazil.
Insights
The Portuguese version of the TRACK questionnaire reliably assesses respiratory symptom control in children, proving useful for clinical evaluation. This validated tool aids in distinguishing varying levels of symptom control in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Clinical Assessment Tools
- Respiratory Health
Background:
- The TRACK (Test for Respiratory and Asthma Control in Kids) questionnaire is an established English tool for assessing respiratory symptom control in young children.
- Validation of translated instruments is crucial for global applicability in pediatric healthcare.
Purpose of the Study:
- To validate the Portuguese version of the TRACK questionnaire for use in Brazilian children.
- To assess the reliability and validity of the translated TRACK questionnaire in a diverse pediatric population.
Main Methods:
- A prospective, multicenter observational study involving children with recurrent respiratory symptoms in Brazil.
- Data collection included parent and physician ratings of symptom control using a Visual Analog Scale (VAS) and classification based on GINA criteria and medical evaluation.
- Statistical analysis included Cronbach's alpha for reliability and correlation coefficients for validity, alongside ROC curve analysis for optimal cut-off points.
Main Results:
- The Portuguese TRACK questionnaire demonstrated satisfactory internal consistency (Cronbach's α = 0.70) and significant correlations with physician (r=0.74) and parent (r=0.61) opinions on symptom control.
- Scores were significantly lower in children who had used systemic steroids or had emergency visits, indicating sensitivity to disease severity.
- A cut-off score of 80 demonstrated the highest accuracy (Area Under ROC curve = 0.800) in discriminating symptom control levels.
Conclusions:
- The Portuguese TRACK questionnaire is a reliable and valid instrument for evaluating respiratory symptom control in children.
- The validated tool can effectively differentiate between varying levels of respiratory symptom control in pediatric patients.
- This facilitates better clinical decision-making and management of respiratory conditions in children speaking Portuguese.
Background:
TRACK (Test for Respiratory and Asthma Control in Kids) questionnaire is an instrument developed and validated in English to evaluate the control of respiratory symptoms in children under 5 years of age.
Objective:
To validate the Portuguese version of the TRACK questionnaire.
Methods:
The validation was done in an observational, prospective and multicenter evaluation (six centers in Brazil) in children with recurrent respiratory symptoms. Children were classified according to symptoms, GINA criteria and medical evaluation. Parents and doctors rated child respiratory symptom control in the last month (VAS). Approval from the Institutional Review Board was obtained in each centre, and written informed consent was obtained from parents.
Results:
Data from 299 children were obtained at baseline, and 195 at follow-up. The median score of the TRACK questionnaire was 65 and Cronbach's α was 0.70. TRACK scores showed significant correlation with the medical and family opinions about symptom control (r: 0.74 and r: 0.61). TRACK scores were significantly lower in children who had used systemic steroids (median [IQR]: 45 [30-65] vs 75 [55-80]; p < 0.001) and had an emergency visit in the last month (45 [35-60] vs 70 [55-80]; p < 0.001). TRACK scores were also significantly different when children were separated by the medical opinion, GINA criteria and symptoms. Comparison of different respiratory symptom control cut-off points showed that the cut-off of 80 points had the highest area under ROC curve (0.800).
Conclusion:
We have demonstrated that the Portuguese version of the TRACK questionnaire has satisfactory reliability (internal consistency), adequate criterion validity (compared against GINA levels of control) and constructive validity (compared against respiratory symptoms and medical opinion), showing that it can be a useful tool to discriminate among children with different levels of respiratory symptom control.
Trial Registration:
ClinicalTrials.gov: NCT03290222.
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