Murphy Kevin R, Zeiger Robert S, Kosinski Mark, Chipps Bradley, Mellon Michael, Schatz Michael, Lampl Kathy, Hanlon Jennifer T, Ramachandran Sulabha
Boys Town National Research Hospital, Allergy, Asthma & Pediatric Pulmonology, 14080 Hospital Road, Omaha, NE 68010, USA.
J Allergy Clin Immunol. 2009 Apr;123(4):833-9.e9. doi: 10.1016/j.jaci.2009.01.058.
A validated questionnaire is needed to monitor respiratory control in preschool-aged children.
We sought to develop and validate a caregiver-completed questionnaire that measures respiratory control in young children.
A 33-item questionnaire that included asthma impairment and risk items was administered to 486 caregivers of children aged younger than 5 years with a current, recent, or past history of respiratory symptoms. Stepwise regression was used to select a subset of items with the greatest discriminant validity in relation to guidelines-defined asthma control in a random two-thirds development sample. Reliability, validity, and ability to screen for respiratory control problems were tested in development and validation samples (remaining one-third sample).
The content of the 5 items selected, the Test for Respiratory and Asthma Control in Kids (TRACK), included frequency of respiratory symptoms (wheeze, cough, shortness of breath), activity limitation, and nighttime awakenings in the past 4 weeks; rescue medication use in the past 3 months; and oral corticosteroid use in the previous year. Reliability was greater than 0.70 in both samples. ANOVA showed that mean scores differed significantly (P < .001) in the expected direction across both samples for 3 levels of guidelines-based respiratory control, physician-recommended change in therapy, and symptom status. In the development and validation samples, screening analyses revealed areas under the receiver operating characteristic curve of 0.88 and 0.82, respectively; control status was correctly classified in 81% and 78% of cases.
TRACK is a valid, easy-to-administer, caregiver-completed questionnaire of respiratory control in preschool-aged children with symptoms consistent with asthma.
需要一份经过验证的问卷来监测学龄前儿童的呼吸控制情况。
我们试图开发并验证一份由照料者填写的问卷，用于测量幼儿的呼吸控制情况。
对486名5岁以下有当前、近期或既往呼吸道症状病史儿童的照料者发放一份包含哮喘损害和风险项目的33项问卷。在随机抽取的三分之二的开发样本中，采用逐步回归法选择与指南定义的哮喘控制具有最大判别效度的项目子集。在开发样本和验证样本（剩余三分之一样本）中测试问卷的信度、效度以及筛查呼吸控制问题的能力。
所选择的5项内容组成了儿童呼吸与哮喘控制测试（TRACK），包括过去4周内呼吸道症状（喘息、咳嗽、呼吸急促）的频率、活动受限情况以及夜间觉醒情况；过去3个月内急救药物的使用情况；以及上一年口服糖皮质激素的使用情况。两个样本中的信度均大于0.70。方差分析显示，在基于指南的三个呼吸控制水平、医生建议的治疗变化以及症状状态方面，两个样本的平均得分在预期方向上存在显著差异（P < .001）。在开发样本和验证样本中，筛查分析显示受试者工作特征曲线下面积分别为0.88和0.82；在81%和78%的病例中正确分类了控制状态。
TRACK是一份有效、易于管理、由照料者填写的问卷，用于评估有哮喘相关症状的学龄前儿童的呼吸控制情况。
