Simple, reliable test assesses respiratory control in preschoolers

A 5-item questionnaire provides a reliable tool for assessing respiratory control in general pediatric practice, according to a study published in Pediatrics.

The Test for Respiratory and Asthma Control in Kids (TRACK [AstraZeneca, Wilmington, Delaware]) originally was developed and validated for use in asthma specialty practices. The current longitudinal study evaluated TRACK’s responsiveness to changes in respiratory- and asthma-control status over time in preschool-aged children treated by pediatricians.

Caregivers (n=438) of children younger than 5 years who had symptoms consistent with asthma within the past year completed TRACK at baseline and 4 to 6 weeks later. The test is based on the impairment and risk domains of the National Asthma Education and Prevention Program Expert Panel Report 3. Each item was scored from 0 to 100 points on a 5-point Likert-type scale, a lower score indicating poorer control of symptoms. At follow-up, caregivers were asked whether the child’s respiratory symptoms were better, worse, or the same as at the previous visit. Physicians blinded to the caregivers’ responses completed a guidelines-based survey at the initial and follow-up visits and were asked about changes in therapy.

The investigators found that mean changes in TRACK scores over time differed significantly in the expected direction in subsets of patients whose clinical status improved, worsened, or remained the same, based on physicians’ and caregivers’ ratings. Children with well-controlled symptoms had the highest mean TRACK scores, whereas those with very poorly controlled symptoms had the lowest mean scores. Similarly, children whose physician recommended a step-up in therapy had significantly lower scores than those whose therapy remained the same or was stepped down.

The findings confirm the validity and reliability of TRACK for use in the general pediatric setting, the researchers say, and indicate that TRACK has the potential to assist with monitoring respiratory and asthma control in preschool-aged children with asthma-like symptoms.

Chipps B, Zeiger RS, Murphy K, et al. Longitudinal validation of the Test for Respiratory and Asthma Control in Kids in pediatric practices. Pediatrics. 2011;127(3):e737-e747.