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Validation of an outpatient questionnaire for bronchopulmonary dysplasia control
Joseph M Collaco1, Yun Li2,3, Lawrence M Rhein4
1Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Insights
A new questionnaire helps assess respiratory symptom control in children with bronchopulmonary dysplasia (BPD). This tool aids clinical care and research, offering a validated method for tracking BPD symptom control in infants and children.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Clinical Trial Methodology
Background:
- Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants.
- Current outpatient assessment of respiratory symptom control in BPD lacks validated objective tools.
- Effective symptom control monitoring is crucial for managing BPD and improving patient outcomes.
Purpose of the Study:
- To develop and validate a standardized questionnaire for assessing outpatient respiratory symptom control in children with BPD.
- To evaluate the reliability, validity, and discriminative properties of the new BPD control questionnaire.
- To determine the relationship between symptom control categories and acute care utilization.
Main Methods:
- A new questionnaire was adapted from an asthma control test.
- Data collected from 1049 preterm infants and children in US tertiary care BPD clinics (2018-2022).
- Validation included internal reliability, construct validity, and discriminative properties against acute care use.
Main Results:
- The majority of caregivers (86.2%) reported their child's BPD symptoms were controlled.
- The BPD control questionnaire demonstrated internal reliability and good discriminative properties.
- Control categories predicted sick visits, emergency department visits, and hospital readmissions.
Conclusions:
- A validated tool is now available for assessing respiratory symptom control in children with BPD for clinical and research settings.
- The BPD control questionnaire can identify children at higher risk for acute care utilization.
- Future research should explore modifiable predictors of BPD control and correlate questionnaire scores with lung function testing.
Introduction:
Despite bronchopulmonary dysplasia (BPD) being a common morbidity of preterm birth, there is no validated objective tool to assess outpatient respiratory symptom control for clinical and research purposes.
Methods:
Data were obtained from 1049 preterm infants and children seen in outpatient BPD clinics of 13 US tertiary care centers from 2018 to 2022. A new standardized instrument was modified from an asthma control test questionnaire and administered at the time of clinic visits. External measures of acute care use were also collected. The questionnaire for BPD control was validated in the entire population and selected subgroups using standard methodology for internal reliability, construct validity, and discriminative properties.
Results:
Based on the scores from BPD control questionnaire, the majority of caregivers (86.2%) felt their child's symptoms were under control, which did not differ by BPD severity (p = 0.30) or a history of pulmonary hypertension (p = 0.42). Across the entire population and selected subgroups, the BPD control questionnaire was internally reliable, suggestive of construct validity (albeit correlation coefficients were -0.2 to -0.4.), and discriminated control well. Control categories (controlled, partially controlled, and uncontrolled) were also predictive of sick visits, emergency department visits, and hospital readmissions.
Conclusion:
Our study provides a tool for assessing respiratory control in children with BPD for clinical care and research studies. Further work is needed to identify modifiable predictors of disease control and link scores from the BPD control questionnaire to other measures of respiratory health such as lung function testing.
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