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Respiratory, asthma control questionnaire shows meaningful changes in clinical symptoms in children
Zeiger RS. J Allergy Clin Immunol. 2011;doi:10.1016/j.jaci.2011.08.010.
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Changes in TRACK scores of at least 10 points represent clinically meaningful changes in respiratory control status in individual young children who have asthma-like respiratory symptoms, results of a new study indicate.
The Test for Respiratory and Asthma Control in Kids (TRACK) is the first validated questionnaire designed specifically for young children to assess respiratory and asthma control. A change in symptom score of more than 10 points “should alert health care providers to re-evaluate asthma management,” Robert S. Zeiger, MD, PhD, and colleagues wrote in a study published online recently.
In this prospective, nonrandomized, longitudinal study conducted at 20 US pediatric sites, the investigators wanted to determine the minimally important difference for interpreting meaningful changes in individual patients’ TRACK scores. TRACK was administered 4 to 6 weeks apart at two separate clinic visits to caregivers of children aged younger than 5 years who had symptoms consistent with asthma.
Anchor-based methods were used to determine the minimally important difference from mean score differences between patients based on six criteria measures: 1) physician guidelines-based respiratory-control rating; 2) physician-recommended changes to therapy; 3) symptoms lasting more than 24 hours during the past 3 months; 4) oral corticosteroid use for respiratory tract illnesses during the past 12 months; 5) physician-assessed change in control status at follow-up; and 6) caregiver-reported change in respiratory status.
TRACK scores were assessed at baseline for 426 caregivers and follow-up for 396 caregivers. Mean differences in TRACK scores between patients differing on criteria measures ranged from 3.4 to 16.4 points. Logistic regression analyses indicated that scoring 10 or more points less than 80 on TRACK was associated with an approximately twofold increased odds of having uncontrolled asthma or respiratory symptoms.
Disclosure: The study was supported by AstraZeneca. Dr. Zeiger has consultant arrangements with AstraZeneca, Aerocrine, Genentech, Merck, Schering-Plough, MedImmune and Sunovion, and receives research support from Aerocrine, Genentech, Merck and GlaxoSmithKline.
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