duRivage Nathalie, Ross Michelle, Mayne Stephanie L, Suh Andrew, Weng Daniel, Grundmeier Robert W, Fiks Alexander G
1 The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
2 University of Pennsylvania, Philadelphia, PA, USA.
Clin Pediatr (Phila). 2017 Apr;56(4):341-347. doi: 10.1177/0009922816675013. Epub 2016 Oct 24.
We compared results of a modified version of the Asthma Control Test using parent proxy report (PP-ACT) with results reported by children and parents using the validated Childhood-Asthma Control Test (C-ACT). 104 parent-child dyads with a child aged 6 to 12 years with asthma were randomized to complete PP-ACT followed by C-ACT or C-ACT followed by PP-ACT. Scores ≤19 indicated uncontrolled asthma. We calculated sensitivity, specificity, positive predictive value, and negative predictive value for the PP-ACT in comparison with the C-ACT, and calculated concordance between the 2 scales. The PP-ACT had sensitivity of 86% and negative predictive value of 88% for detecting uncontrolled asthma. More than 75% of surveys were concordant (κ = 0.54, moderate agreement). Our results suggest that while the PP-ACT missed few children with uncontrolled asthma and may simplify reporting of asthma control in circumstances when child report is not feasible or creates barriers to survey receipt, limitations of proxy reporting should be considered.
我们将使用家长代理报告（PP-ACT）的改良版哮喘控制测试结果与儿童和家长使用经过验证的儿童哮喘控制测试（C-ACT）报告的结果进行了比较。104对患有哮喘的6至12岁亲子被随机分配，先完成PP-ACT，然后完成C-ACT，或者先完成C-ACT，然后完成PP-ACT。得分≤19表明哮喘未得到控制。我们计算了与C-ACT相比PP-ACT的灵敏度、特异度、阳性预测值和阴性预测值，并计算了两个量表之间的一致性。PP-ACT检测未控制哮喘的灵敏度为86%，阴性预测值为88%。超过75%的调查结果一致（κ = 0.54，中度一致性）。我们的结果表明，虽然PP-ACT遗漏的哮喘未得到控制的儿童很少，并且在儿童报告不可行或对调查接收造成障碍的情况下可能简化哮喘控制的报告，但应考虑代理报告的局限性。
