- 作者：Robert S. Zeiger MD ; PhD<sup>asup><sup> ; ; sup><sup>Robert.S.Zeiger@kp.orgsup> ; Michael Mellon MD<sup>asup> ; Bradley Chipps MD<sup>bsup> ; Kevin R. Murphy MD<sup>csup> ; Michael Schatz MD<sup>asup> ; Mark Kosinski MA<sup>dsup> ; Kathy Lampl MD<sup>esup> ; Sulabha Ramachandran PhD<sup>fsup>
- 关键词：Asthma ; asthma control ; epidemiologic measurements ; questionnaire ; pediatric ; preschool children ; risk ; validation studies ; wheezing
- 刊名：Journal of Allergy and Clinical Immunology
- 出版年：2011
- 出版时间：November 2011
- 年：2011
- 卷：128
- 期：5
- 页码：983-988
- 全文大小：361 K
ss=""h4"">Background
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.ss=""h4"">Objective
We sought to determine the minimally important difference (MID) for interpreting meaningful changes in individual patients' TRACK scores.
ss=""h4"">Methods
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¨Cbased 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.
ss=""h4"">Results
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.
ss=""h4"">Conclusion
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.