Ortega A N, Belanger K D, Bracken M B, Leaderer B P
Division of Health Policy and Administration, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA.
Ann Allergy Asthma Immunol. 2001 Apr;86(4):405-13. doi: 10.1016/S1081-1206(10)62486-6.
Although there are current measures to evaluate childhood asthma severity for clinical diagnosis and treatment, there is no standard valid measure to evaluate childhood asthma severity for large-scale epidemiologic studies.
To develop and test a childhood asthma severity scale (CHAS) for clinimetric validity and to determine differences in symptoms, medication use, and health care visits by participant characteristics.
Eight hundred ninety-seven actively asthmatic children under the age of 12 years were selected from a general population of children. Children were selected from a screening questionnaire administered at six Connecticut hospitals that serve large minority populations in Bridgeport, New Haven, Hartford, and Danbury and one hospital serving south central Massachusetts. Twelve-month baseline data for a prospective cohort study of childhood asthma severity were collected on a monthly basis through home interviews. Home interviews addressed questions on daily symptoms, medication use, and health care visits. A severity scale was constructed using three dimensions: symptoms, medication use, and health care visits.
CHAS has sufficient preliminary content, construct, and predictive validity. Despite similarities in symptoms, there were health care utilization and medication differentials according to race and ethnicity, insurance status, family income, and maternal education.
CHAS is a potentially useful measure of asthma severity for large-scale epidemiologic studies. It seems that CHAS has sufficient clinimetric properties.
尽管目前有用于临床诊断和治疗的儿童哮喘严重程度评估方法，但尚无用于大规模流行病学研究的评估儿童哮喘严重程度的标准有效方法。
开发并测试一种儿童哮喘严重程度量表（CHAS）的临床测量效度，并根据参与者特征确定症状、药物使用及医疗就诊方面的差异。
从儿童总体人群中选取897名12岁以下的活动性哮喘患儿。这些儿童来自在布里奇波特、纽黑文、哈特福德和丹伯里服务大量少数族裔人群的康涅狄格州的六家医院以及服务马萨诸塞州中南部的一家医院所进行的筛查问卷。通过家庭访谈每月收集一项关于儿童哮喘严重程度的前瞻性队列研究的12个月基线数据。家庭访谈涉及日常症状、药物使用及医疗就诊方面的问题。使用症状、药物使用和医疗就诊三个维度构建严重程度量表。
CHAS具有足够的初步内容效度、结构效度和预测效度。尽管症状相似，但根据种族和族裔、保险状况、家庭收入及母亲教育程度，在医疗保健利用和药物使用方面存在差异。
CHAS对于大规模流行病学研究而言是一种潜在有用的哮喘严重程度测量方法。似乎CHAS具有足够的临床测量特性。
