Nkoy FL, Stone BL, Fassl BA, Uchida DA, Koopmeiners K, Halbern S, Kim EH, Wilcox A, Ying J, Greene TH, Mosen DM, Schatz MN, Maloney CG. Longitudinal validation of a tool for asthma self-monitoring.
Pediatrics 2013;
132:e1554-61. [PMID:
24218469 PMCID:
PMC4074668 DOI:
10.1542/peds.2013-1389]
[Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2013] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES
To establish longitudinal validation of a new tool, the Asthma Symptom Tracker (AST). AST combines weekly use of the Asthma Control Test with a color-coded graph for visual trending.
METHODS
Prospective cohort study of children age 2 to 18 years admitted for asthma. Parents or children (n = 210) completed baseline AST assessments during hospitalization, then over 6 months after discharge. Concurrent with the first 5 AST assessments, the Asthma Control Questionnaire (ACQ) was administered for comparison.
RESULTS
Test-retest reliability (intraclass correlation) was moderate, with a small longitudinal variation of AST measurements within subjects during follow-ups. Internal consistency was strong at baseline (Cronbach's α 0.70) and during follow-ups (Cronbach's α 0.82-0.90). Criterion validity demonstrated a significant correlation between AST and ACQ scores at baseline (r = -0.80, P < .01) and during follow-ups (r = -0.64, -0.72, -0.63, and -0.69). The AST was responsive to change over time; an increased ACQ score by 1 point was associated with a decreased AST score by 2.65 points (P < .01) at baseline and 3.11 points (P < .01) during follow-ups. Discriminant validity demonstrated a strong association between decreased AST scores and increased oral corticosteroid use (odds ratio 1.13, 95% confidence interval, 1.10-1.16, P < .01) and increased unscheduled acute asthma visits (odds ratio 1.23, 95% confidence interval, 1.18-1.28, P < .01).
CONCLUSIONS
The AST is reliable, valid, and responsive to change over time, and can facilitate ongoing monitoring of asthma control and proactive medical decision-making in children.
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