Test For Respiratory And Asthma Control In Kids Scores Research Articles

Correlation between impulse oscillometry parameters and test for respiratory and asthma control in kids (TRACK) in asthma control of preschoolers with asthma

Little research has been conducted to evaluate the correlation between impulse oscillometry (IOS), Childhood Asthma Control Test (C-ACT), and Test for Respiratory and Asthma Control in Kids (TRACK). This study was conducted at China Medical University Hospital between September 1, 2019, and March 31, 2021. Children aged 2-6 years who had been diagnosed with asthma with acute exacerbation were enrolled and followed-up until the end of the study. Correlations between the parameters of IOS, C-ACT and TRACK were assessed. The validity and reliability of TRACK were verified. A total of 114 children with asthma and acute exacerbations were recruited. Their mean age was 4.1±1.1 years, and 60.5% were males. After a year of treatment, the change of R5-R20 from baseline 0.64±0.38kPa/L/s to 12th month 0.48±0.2kPa/L/s (p=0.022). TRACK and C-ACT scores were significantly correlated during the observation period. R5-R20 in IOS at baseline and at the 12th month of follow-up as well as the change in IOS parameters were significantly associated with C-ACT (p=0.003, 0.015, and 0.001, respectively). R5% and R5-R20 changes in IOS were associated with TRACK (p=0.04 and 0.025, respectively). Sensitivity and specificity of TRACK were 80.8% (67.5-90.4) and 100% (94.1-100), respectively, with cut-off points >95 and AUC 93.8%. TRACK score appears to have a stronger association with the IOS parameter than C-ACT score. Our findings indicate that TRACK is a valid tool for assessing asthma control in preschool children.

Impact of Asthma Education Program 2020-2021 on Asthma Control Among Bronchial Asthma Children in Madinah City, Saudi Arabia.

Asthma control among asthmatic children still remains suboptimal. Saudi literature are scarce in this context, and there is a paucity of reports that compare asthma control level pre- and post-education program directed to asthmatic patients and their parents. The objective of this study was to assess the impact of asthma education and flu vaccination on asthma control in asthmatic children in Madinah region from2020 to 2021, in terms of ED visits, hospitalization, pediatric intensive care unit (PICU) admission, and asthma control level. A cross-sectional study was conducted at primary health care (PHC) centers in Al-Madinah City, Saudi Arabia. The study analyzed data from 804 asthmatic children patients from randomly selected six PHC centers. The data were collected by a valid structured questionnaire. The questionnaire included socio-demographic and clinical data. Child asthma symptoms control was examined by the Childhood Asthma Control Test (C-ACT) for children aged 5-12 years, and the Test for Respiratory and Asthma Control in Kids (TRACK) for children less than five years of age. The collected data were analyzed using the appropriate statistical tests. The mean age of the studied children was 6.1±3.0 (1-14 years), with 59.8% of them being males. There have been statistically significant reductions for asthmatic children in ED visits/month, hospitalization, and pediatric ICU admission/years in the post-education groups for all studied patients and patients <five years and five to 12 years. The average ACT and TRACK scores were significantly higher in the post-education group. The controlled asthma was also significantly higher among post-education groups. The rate of ED visits, hospitalization, critical care needs, and PICU admission significantly decreased among children receiving flu vaccination. This study emphasizes the role of asthma education and flu vaccination in improving asthma control status of asthmatic children and in decreasing the rate of ED visits, hospitalization, and critical care needs. More longitudinal and experimental studies are needed to confirm these findings.

Effectiveness of a Home- and School-Based Asthma Educational Program for Head Start Children With Asthma: A Randomized Clinical Trial

To evaluate if a multilevel home and preschool asthma educational program is more effective in improving asthma control, compared with a preschool-based program alone. Specifically, because this study was conducted within the Head Start program and targeted at an at risk population, with the study, the researchers examined if their multilevel intervention could address asthma disparities.Eligible participants were caregivers with children aged 2 to 6 years with the confirmed physician-diagnosed of asthma who were also enrolled in one of 14 Head Start programs in Baltimore, Maryland. Participants were recruited from April 1, 2011, to November 31, 2016.Screening forms were provided through Head Start staff, and families who gave permission were contacted by telephone to confirm eligibility and schedule the first home visit. Families were randomly assigned to either the Action for a Better Community (ABC) Plus Head Start education group or the Head Start education alone group by using a 1:1 block randomization scheme. Families were not blinded to their random assignment, but the research assistants who completed assessments were blinded and were different from the intervention staff. The ABC family intervention consisted of 4 30- to 45-minute in-person, at-home asthma management educational sessions and 3 booster calls. Assessment visits were completed by research assistants: in home visits at baseline and 6 months and telephone visits at 3, 9, and 12 months. The primary outcome was the Test for Respiratory and Asthma Control in Kids (TRACK) score to assess the degree of asthma control. Caregiver reports of emergency department visits, hospitalizations, and courses of oral corticosteroids (OCS) in the previous 3 months were collected at each assessment visit. Caregiver health–related quality of life was measured by using the Pediatric Asthma Caregiver’s Quality of Life Questionnaire.A total of 398 families were randomly assigned to either the ABC Plus Head Start educational program (n = 199) or Head Start educational program alone (n = 199). Most participants were Black (379 [95.2%]) and had a family income of less than $40 000 a year (357 [89.7%]). There were no significant group differences on any demographic characteristic. Of those in the intervention group, 144 (72.4%) completed at least 1 home education session, 69 (34.7%) completed all 4 home visits, and 71 (35.8%) completed all the booster telephone calls after the 3-, 6-, and 9-month follow-up surveys. Although there was an overall improvement in TRACK total scores for both groups over time (β = 3.00; 95% confidence interval (CI): 2.47 to 3.54; P < .001), those in the intervention group had clinically significant score differences at 3 months, compared with that of those in the control group (β = 6.26; 95% CI: 1.77 to 10.75; P < .001). There was no significant difference in TRACK scores among groups at months 6, 9, and 12. Participants in the intervention group were significantly less likely to have OCS use at 9 months (β = −0.61; 95% CI: −1.13 to −0.09; P = .02) and hospitalization during the 12-month follow-up period (odds ratio: 0.36; 95% CI: 0.21 to 0.61; P < .001). There was a significant improvement in asthma-related quality of life at 12 months for both groups (β = 0.28; 95% CI: 0.19 to 0.38; P < .001) but no difference between intervention and control groups.The multilevel asthma education intervention decreased several measures including asthma symptom scores at 3 months, OCS use at 9 months, and decreased hospitalizations during the 12-month follow-up period.This educational program revealed modest improvements in asthma control and health care use. It is not entirely clear why TRACK scores only revealed differences at 3 months and OCS use at 9 months; however, the decrease in asthma hospitalization during 12-month follow-up indicates a true significant effect, especially because preschool-aged children have the highest risk for use of health care services. However, it should be noted that health care resources for asthma outcomes was collected via caregiver report and not verified by using medical records, possibly leading to bias. Overall, with this study, the authors highlight how implementation of an asthma educational program by using a community partner was an effective strategy for targeting a population disproportionately affected by health disparities.

Cross-cultural validation of the Portuguese from Portugal version of the Test for Respiratory and Asthma Control in Kids (TRACK) questionnaire.

Introduction. The Test for Respiratory and Asthma Control in Kids (TRACK) is a tool to assess asthma control in preschool children. This study aims to validate the Portuguese from Portugal version of the TRACK questionnaire. Methods. A prospective cohort study was carried out to assess their psychometric characteristics. Caregivers of 141 children under age 5 with asthma symptoms were enrolled. Results. Internal reliability was close to 0.70 (Cronbach's α). The test-retest reliability was 0.87. TRACK scores were different between well, partially, and non-controlled asthma groups (p less than 0.001). Patients rated as having better control showed an increase in TRACK scores. Conclusions. The Portuguese version of the TRACK questionnaire is accurate and reliable for monitoring asthma control. Its use may help to overcome challenges with the management of this age group.

The Relationship of the Test for Respiratory and Asthma Control in Kids Initial Score on the Prognosis of Pre-school Children With Asthma: A Prospective Cohort Study

Objective: The test for respiratory and asthma control in kids (TRACK) is currently the only standard follow-up tool for children under 5 years of age with asthma. The purpose of this study was to investigate the relationship between the TRACK initial score (Ti) and their prognosis after 6 months of follow-up in pre-schoolers with asthma.Design: A prospective cohort study.Methods: The study included pre-schoolers diagnosed with asthma at the Shanghai Children's Medical Center between January 2019 and June 2020, and follow-up for 6 months. TRACK scores, frequency of wheezing and respiratory infections, number of Emergency Department (ED) visits and treatment regimen were collected. According to the TRACK initial score, the children were divided into “Ti < 60 group” and “Ti ≥ 60 group,” and the two groups were compared in terms of TRACK score related indicators, clinical manifestations and treatment.Results: There are 102 pre-schoolers included in the analysis [78 boys (76.5%) and 24 girls (23.5%); mean (SD) age, 28.05 (11.63) months]. After 6 months of follow-up, the TRACK score was improved in both groups, and the “Ti ≥ 60 group” had a higher score, lower rate of uncontrolled asthma and fewer reassessments were required. There was no difference in the number of wheezing attacks between the two groups in terms of clinical presentation, but the “Ti < 60 group” had more respiratory infections and ED visits. Regarding the use of ICSs, in the “Ti < 60 groups,” the dose of ICSs was higher and reduced slowly, and the dose difference between the two groups began to appear after 5 months of follow-up.Conclusion: TRACK is essential for pre-schoolers with asthma at the time they are diagnosed. In addition, if the TRACK initial score is < 60, the probability of poor prognosis is higher.

Persistent ventilation inhomogeneity after an acute exacerbation in preschool children with recurrent wheezing.

Preschool children with recurrent wheezing suffer high morbidity. It is unclear whether objective measures of asthma control, such as pulmonary function tests (PFTs), provide additional information to the clinical assessment. We recruited children between 3 and 6years old, with a history of recurrent wheezing in the preceding year and treated for acute wheezing exacerbation in the emergency department (ED) into an observational cohort study. Children attended two outpatient visits: the first study visit within five days of discharge from the ED and the second study visit 12weeks after the ED visit. We performed standardized symptom score (test for respiratory and asthma control in kids (TRACK)), multiple breath washout (MBW), spirometry, and clinical assessment at both visits. Seventy-four children, mean (standard deviation (SD)) age of 4.32years (0.84), attended both visits. Paired FEV0.75 and lung clearance index (LCI) measurements at both time points were obtained in 37 and 34 subjects, respectively. Feasibility for all tests improved at visit 2 and was not age-dependent. At the second study visit, a third had controlled asthma based on the TRACK score, and the mean lung clearance index (LCI) improved from 9.86 to 8.31 (P=.003); however, 46% had an LCI in the abnormal range. FEV0.75 z-score improved from -1.66 to -1.17 (P=.05) but remained in the abnormal range in 24%. LCI was abnormal in more than half of the children with "well-controlled" asthma based on the TRACK score. There was no correlation between PFT measures and TRACK scores at either visit. Lung clearance index demonstrates a persistent deficit post-exacerbation in a large proportion of preschoolers with recurrent wheezing, highlighting that symptom scores alone may not suffice for monitoring these children.

Comparison between modified Chinese Version of Test for Respiratory and Asthma Control in Kids and Global Initiative for Asthma guideline

Objective To explore the value of modified Chinese Version of Test for Respiratory and Asthma Control in Kids(TRACK) in the management of asthmatic children aged 0-5 years old by comparing with Global Ini-tiative for Asthma(GINA) guideline. Methods A total of 157 children aged 0-5 years old were enrolled at the Pedia-tric Asthma Outpatient Department of the Affiliated Hospital of Qingdao University from March to August 2018.All children were treated with individualized anti-asthma treatment for 3 months.After treatment, asthma experts assessed the level of asthma symptom control based on the GINA guideline, while caregivers of all children completed TRACK questionnaire.The optimal threshold of the TRACK questionnaire for asthma control was determined by analyzing receiver operating characteristic curve(ROC curve), and consistency of the 2 evaluation methods was compared. Results All enrolled children were divided into 3 groups based on GINA guideline: 59 children for the well controlled group, 52 children for the partly controlled group and 46 children for the uncontrolled group.There was a significant difference statistically in TRACK scores among the well controlled group [90(85, 95) scores], the partly controlled group [80(70, 85) scores] and the uncontrolled group [60(55, 65) scores] after treatment (H=101.740, P<0.001). Area under the ROC curve was 0.909 for diagnosing asthma control by the modified Chinese version of TRACK, with 80 scores for optimal threshold, 87.3% for sensitivity and 73.5% for specificity.The Kappa value of the consistency test between the TRACK questionnaire and the GINA guideline was 0.553, and consistency rate of these 2 evaluation methods was 77.1%. Conclusions The modified Chinese version of TRACK can be used as an effective assessment tool to monitor and manage asthmatic children aged 0-5 years. Key words: Modified Chinese Version of Test for Respiratory and Asthma Control in Kids; Global Initiative for Asthma; Asthma management

Reliability and validity of the Chinese version of the Test for Respiratory and Asthma Control in Kids (TRACK) in preschool children with asthma: a prospective validation study

ObjectiveThe limited existing asthma control questionnaires that are available for children 5 years of age or younger in China mostly assess only the impairment domain of asthma control. Here, the...

The Korean Version of the Test for Respiratory and Asthma Control in Kids (TRACK): Reliability and Validity.

BackgroundTest for Respiratory and Asthma Control in Kids (TRACK) questionnaires were developed and validated in various languages to monitor respiratory control in preschool-aged children. We aimed to assess the reliability and validity of the Korean version of the TRACK questionnaire.MethodsWe administered the linguistically validated TRACK questionnaires to caregivers of asthmatic preschool children on two separate visits 4–6 weeks apart. Each physician graded the level of the guideline-based asthma control, assessed the timing of symptoms, and adjusted the therapeutic level at each visit.ResultsA total of 137 children were enrolled in the study. Cronbach's alpha was 0.65 for a questionnaire as a whole. The test-retest reliability was 0.72. The median TRACK scores were significantly different between asthma control status categories, with the lowest scores in children classified as poorly controlled and the highest in the well-controlled group (P < 0.001). They were different among groups classified according to the physician adjusted therapeutic levels, with the lowest values in children prescribed step-up therapy (P < 0.001), and according to the recency of respiratory symptoms (P < 0.001). Finally, the changes in TRACK scores between visits were highest in subjects showing improved control, followed by unchanged, and worsened control. When we applied the traditional cut-off of 80 for a well-controlled condition, a sensitivity of 75.6% and a specificity of 70.9% were calculated.ConclusionThe Korean translated version of the TRACK questionnaire is valid and reliable to assess respiratory and asthma control in Korean preschool children with asthma symptoms.

Test for Respiratory and Asthma Control in Kids (TRACK): validation of the Portuguese version

Background TRACK (Test for Respiratory and Asthma Control in Kids) questionnaire is an instrument developed and validated in English to evaluate the control of respiratory symptoms in children under 5 years of age.Objective To validate the Portuguese version of the TRACK questionnaire.Methods The validation was done in an observational, prospective and multicenter evaluation (six centers in Brazil) in children with recurrent respiratory symptoms. Children were classified according to symptoms, GINA criteria and medical evaluation. Parents and doctors rated child respiratory symptom control in the last month (VAS). Approval from the Institutional Review Board was obtained in each centre, and written informed consent was obtained from parents.Results Data from 299 children were obtained at baseline, and 195 at follow-up. The median score of the TRACK questionnaire was 65 and Cronbach’s α was 0.70. TRACK scores showed significant correlation with the medical and family opinions about symptom control (r: 0.74 and r: 0.61). TRACK scores were significantly lower in children who had used systemic steroids (median [IQR]: 45 [30–65] vs 75 [55–80]; p < 0.001) and had an emergency visit in the last month (45 [35–60] vs 70 [55–80]; p < 0.001). TRACK scores were also significantly different when children were separated by the medical opinion, GINA criteria and symptoms. Comparison of different respiratory symptom control cut-off points showed that the cut-off of 80 points had the highest area under ROC curve (0.800).Conclusion We have demonstrated that the Portuguese version of the TRACK questionnaire has satisfactory reliability (internal consistency), adequate criterion validity (compared against GINA levels of control) and constructive validity (compared against respiratory symptoms and medical opinion), showing that it can be a useful tool to discriminate among children with different levels of respiratory symptom control.Trial registration ClinicalTrials.gov: NCT03290222.

Validation of the Spanish Version of the Test for Respiratory and Asthma Control in Kids (TRACK) in a Population of Hispanic Preschoolers

There is a critical need for validation studies of questionnaires designed to assess the level of control of asthma in children younger than 5 years old. To validate the Spanish version of the Test for Respiratory and Asthma Control in Kids (TRACK) questionnaire in children younger than age 5 years with symptoms consistent with asthma. In a prospective cohort validation study, parents and/or caregivers of children younger than age 5 years and with symptoms consistent with asthma, during a baseline and a follow-up visit 2 to 6 weeks later, completed the information required to assess the content validity, criterion validity, construct validity, test-retest reliability, sensitivity to change, internal consistency reliability, and usability of the TRACK questionnaire. Median (interquartile range) of the TRACK scores were significantly different between patients with well-controlled asthma, patients with not well-controlled asthma, and patients with very poorly controlled asthma (90.0 [75.0-95.0], 75.0 [55.0-85.0], and 35.0 [25.0-55.0], respectively, P < .001). TRACK scores were significantly different between patients classified as currently symptomatic and symptomatic in the recent past (42.5 [25.0-55.0] vs 85.0 [75.0-90.0]; P < .001). The intraclass correlation coefficient of the measurements was 0.755 (95% CI, 0.503-1.00). All patients whose clinical status changed showed an increase of 10 or more points in TRACK score between baseline and follow-up visits. The Cronbach α was 0.77 for the questionnaire as a whole. The Spanish version of the TRACK questionnaire has excellent sensitivity to change and usability; adequate criterion validity, construct validity, and test-retest reliability; and an acceptable internal consistency, when used in children younger than age 5 years with symptoms consistent with asthma.

Validation of the Turkish version of “Test for Respiratory and Asthma Control in Kids (TRACK)” questionnaire

Background: Test for Respiratory and Asthma Control in Kids (TRACK) questionnaire is the first to measure both the risk and impairment domains of the current guidelines in preschool children. We aimed to measure the reliability, validity and responsiveness of the Turkish version of the TRACK. Methods: A total of 268 children (69.8% boys) were included in the study. Caregivers responded to three individual TRACK questionnaires, at each clinical visit (baseline, 1st month, and 3rd month). At each visit, physicians determined the control level and the treatment strategy based on the GINA guideline recommendations. Results: The internal consistency reliability of the Turkish version of the TRACK questionnaire was found to be 0.74, 0.74, and 0.76 at each of the three visits, respectively (reliability statistics, Cronbach’s alpha). There was a significant difference between the mean TRACK scores of the patients in different asthma control status categories (p < 0.001). The test-retest reliability in stable patients was 0.90. The optimal cut-off scores according to the Youden index were 80 and 60 points for uncontrolled and very poorly controlled children, respectively. Conclusion: The Turkish version of the TRACK is an accurate and reliable tool for evaluating asthma control status among preschool Turkish children. Its widespread use may help physicians correctly assess control levels among children and may improve the quality of life for both patients and their caregivers.

Test for Respiratory and Asthma Control in Kids (TRACK): Clinically meaningful changes in score

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. We sought to determine the minimally important difference (MID) for interpreting meaningful changes in individual patients' TRACK scores. 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-based 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. 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. 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.

Longitudinal Validation of the Test for Respiratory and Asthma Control in Kids in Pediatric Practices

The 5-item, caregiver-completed Test for Respiratory and Asthma Control in Kids (TRACK) was developed and validated primarily in asthma-specialist practices to monitor respiratory control in preschool-aged children. This longitudinal study in children treated by pediatricians evaluated the responsiveness of TRACK to changes in respiratory- and asthma-control status over time and further assessed TRACK's reliability and validity. Caregivers of children younger than 5 years with symptoms consistent with asthma within the past year (N = 438) completed TRACK at 2 clinic visits separated by 4 to 6 weeks. Physicians were blinded to caregiver assessment, completed a guidelines-based respiratory-control survey at both visits, and were asked whether the visit resulted in a change in therapy. Responsiveness of TRACK to change in respiratory-control status over time was evaluated; reliability and discriminant validity were assessed. Mean changes in TRACK scores from the initial to follow-up visits differed in the expected direction in subsets of children whose clinical status improved, remained unchanged, or worsened based on physicians' and caregivers' assessments (P < .001). Mean TRACK scores also differed significantly (P < .001) across patient subsets, with lower scores (indicating poorer control) in children classified as very poorly controlled, in those who required a step-up in therapy, and in those who had 4 or more episodes or attacks of wheezing, coughing, or shortness of breath per week in the past 3 months. The present study extends the validity and reliability of TRACK by demonstrating its responsiveness to change in respiratory-control status over time in preschool-aged children with symptoms consistent with asthma.