Allergy Department, Kaiser Permanente, Southern California Region, San Diego, Calif 92111, USA.
J Allergy Clin Immunol. 2011 Nov;128(5):983-8. doi: 10.1016/j.jaci.2011.08.010. Epub 2011 Sep 8.
The Test for Respiratory and Asthma Control in Kids (TRACK) is the first validated questionnaire to assess respiratory and asthma control exclusively in young children.
We sought to determine the minimally important difference (MID) for interpreting meaningful changes in individual patients' TRACK scores.
In this prospective, nonrandomized, longitudinal study conducted at 20 US pediatric sites, TRACK was administered at 2 separate clinic visits (4-6 weeks apart) to caregivers of children aged less than 5 years with symptoms consistent with asthma. Anchor-based methods were used to determine the MID from mean score differences between patients based on multiple criteria measures: physician guidelines-based respiratory control rating, physician-recommended changes to therapy, episodes of symptoms lasting more than 24 hours in the past 3 months, oral corticosteroid use for respiratory tract illnesses in the past year, physician-assessed change in control status at follow-up, and caregiver-reported change in respiratory status. The MID also was determined from distribution-based methods.
TRACK scores were assessed at baseline (426 caregivers) and follow-up (396 caregivers). Mean differences in TRACK scores between patients differing on criteria measures ranged from 3.4 to 16.4 points (mean, 11.1 points). Distribution-based techniques confirmed these findings. Based on logistic regression analyses, scoring 10 or more points less than 80 on TRACK was associated with an approximately 2-fold increased odds of having uncontrolled asthma or respiratory symptoms.
Changes in TRACK scores of 10 or more points represent clinically meaningful changes in respiratory control status in individual young children with respiratory symptoms consistent with asthma and should alert health care providers to re-evaluate asthma management.
儿童呼吸和哮喘控制测试（TRACK）是第一个专门评估幼儿呼吸和哮喘控制的经过验证的问卷。
我们旨在确定用于解释个体患者 TRACK 评分中有意义变化的最小重要差异（MID）。
在这项前瞻性、非随机、纵向研究中，在 20 个美国儿科地点进行，TRACK 在 2 次单独的就诊时（相隔 4-6 周）由年龄小于 5 岁、有与哮喘一致症状的儿童的照顾者进行。基于多种标准措施的锚定方法用于从基于患者的平均评分差异确定 MID：基于医生指南的呼吸控制评分、医生建议的治疗改变、过去 3 个月中持续超过 24 小时的症状发作、过去一年中因呼吸道疾病使用口服皮质类固醇、随访时医生评估的控制状态变化以及照顾者报告的呼吸状态变化。MID 也可以通过分布方法确定。
TRACK 评分在基线（426 名照顾者）和随访（396 名照顾者）时进行评估。在标准措施不同的患者之间，TRACK 评分的平均差异从 3.4 到 16.4 分（平均 11.1 分）。基于分布的技术证实了这些发现。基于逻辑回归分析，在 TRACK 上得分低于 80 分且相差 10 分或更多与哮喘或呼吸道症状控制不佳的可能性增加约 2 倍相关。
TRACK 评分变化 10 分或更多分表示有呼吸道症状且符合哮喘的个体幼儿的呼吸控制状态发生了有临床意义的变化，这应提醒医疗保健提供者重新评估哮喘管理。
