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Matsunaga M, Sato Y, Nagao M, Ikeda M, Motomura C, Kameda M, Yoshida Y, Terada A, Miyairi I, Fujisawa T. Development and validation of a new asthma questionnaire to help achieve a high level of control in school-age children and adolescents. Allergol Int 2024; 73:224-230. [PMID: 38065704 DOI: 10.1016/j.alit.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Maintaining good asthma control minimizes the risk of exacerbations and lung function decline and is a primary goal of asthma management. The Japanese Pediatric Asthma Guidelines (JPGL) employs different classification criteria for control status from other guidelines, stressing a higher level of control. Based on JPGL, we previously developed a caregiver-completed questionnaire for assessing and achieving best asthma control in preschoolers. In this study, we aimed to develop a questionnaire for school-age children and adolescents. METHODS A working questionnaire comprising 14 items for patients and 34 items for caregivers was administered to 362 asthma patients aged 6-15 years and their caregivers. Separately, physicians filled out a questionnaire to determine JPGL-defined control. Logistic regression analysis was performed to construct a model to predict control levels using data from a randomly selected set of completed questionnaires from two-thirds of the subjects. Validation was performed using the remaining questionnaires. RESULTS A set of 7 questions, encompassing self-assessed control status at the time of the visit and in the past month, and nocturnal/early morning asthma symptoms for patients and frequency of asthma symptoms, dyspnea, rescue beta-agonist use, and asthma hospitalization for caregivers, were selected and the 7-item model showed a good statistical fit with AIC of 110.5. The model has been named the Best Asthma Control Test for School Children and Adolescents (Best ACT-S). Best ACT-S scores differed significantly in the hypothetical direction among the groups of different JPGL-defined control levels, step-up/down treatment decisions, and presence/non-presence of exacerbations in the previous year. CONCLUSIONS The Best ACT-S is a valid questionnaire for children/adolescents aiming for best asthma control.
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Affiliation(s)
- Mayumi Matsunaga
- Allergy Center, National Hospital Organization Mie National Hospital, Mie, Japan; Department of Pediatrics, Hamamatsu University Graduate School of Medicine, Hamamatsu, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Mizuho Nagao
- Allergy Center, National Hospital Organization Mie National Hospital, Mie, Japan
| | - Masanori Ikeda
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Chikako Motomura
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | - Yukinori Yoshida
- Department of Pediatrics, Osaka Habikino Medical Center, Osaka, Japan
| | | | - Isao Miyairi
- Department of Pediatrics, Hamamatsu University Graduate School of Medicine, Hamamatsu, Japan
| | - Takao Fujisawa
- Allergy Center, National Hospital Organization Mie National Hospital, Mie, Japan.
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Arakawa H, Adachi Y, Ebisawa M, Fujisawa T, Arakawa H, Adachi Y, Ebisaw M, Fujisawa T, Akasawa A, Inoue T, Ohya Y, Kameda M, Kurihara K, Shimojo N, Suehiro Y, Mochizuki H, Yoshihara S, Iwanaga T, Kuroki H, Takase M, Masuko I, Hirai K, Yoshida K, Inoue Y, Nagao M, Miyaji Y, Iio M, Ito Y, Takizawa T, Futamura M, Tezuka J, Fukuda H, Yoshida Y, Nishimoto H, Fukuie T, Sato S, Yamada Y, Okafuji I, Yamamoto-Hanada K, Sasaki M, Tanaka Y, Nakajima Y, Isozaki A, Inage E, Yagi H, Shimizu M, Akashi K, Kawamoto N, Manabe T, Murai H, Takaoka Y, Miura T, Hiraguchi Y, Sugiyama T, Sugimoto M, Suzuki S, Natsume O, Kitazawa H, Yamaide A, Wada T, Nishima S. Japanese guidelines for childhood asthma 2020. Allergol Int 2020; 69:314-330. [PMID: 33213779 DOI: 10.1016/j.alit.2020.02.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 02/18/2020] [Indexed: 10/24/2022] Open
Abstract
The Japanese Guideline for Childhood Asthma (JGCA) 2020 is a translation of the Japanese Pediatric Guideline for the Treatment and Management of Asthma (JPGL) 2017 into English, which was published by the Japanese Society of Pediatric Allergy and Clinical Immunology. It makes recommendations for best practices in the management of childhood asthma, including management of acute exacerbations and non-pharmacological and pharmacological management. These guidelines will be of interest to non-specialist physicians involved in the care of children with asthma. In JPGL, JPGL2017 is the first evidence-based guidelines updated according to the GRADE system and Minds approach, and it addresses eight clinical questions about the treatment of childhood asthma. In children aged ≤5 years, infant and preschool asthma is diagnosed according to the response to short acting beta2 agonists or the effect of a therapeutic trial during 1 month with controller treatment and worsening after treatment cessation. Long-term management both promotes pharmacological therapy and measures against risk factors that induce exacerbation, better patient education and a partnership with trinity. In addition, long-term management should not be carried out without review but rather be based on a cycle of evaluation, adjustment and treatment. In JPGL2017, the transdermal patch and oral beta2 agonists are positioned as drugs within the concept of "short-term additional treatment" to be used until the symptoms are stabilized when the control state transiently deteriorates.
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Choi YJ, Jang GC, Yang HJ, Kim HB, Yoo Y, Shin M, Lee SY, Kim J, Kim WK, Suh DI, Koh YY. The Korean Version of the Test for Respiratory and Asthma Control in Kids (TRACK): Reliability and Validity. J Korean Med Sci 2019; 34:e25. [PMID: 30662389 PMCID: PMC6335117 DOI: 10.3346/jkms.2019.34.e25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 10/31/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Test 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. METHODS We 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. RESULTS A 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. CONCLUSION The Korean translated version of the TRACK questionnaire is valid and reliable to assess respiratory and asthma control in Korean preschool children with asthma symptoms.
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Affiliation(s)
- Yun Jung Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Sowha Children's Hospital, Seoul, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jakyoung Kim
- Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Young Yull Koh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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Sacchetti M, Baiardini I, Chini L, Moschese V, Bruscolini A, Lambiase A. Development and preliminary validation of a new screening questionnaire for identifying atopic children. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2017; 8:99-105. [PMID: 29388629 PMCID: PMC5774591 DOI: 10.2147/phmt.s142271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Allergic diseases represent a frequent and increasing condition affecting children. A screening questionnaire allowing an easy identification of children with symptoms of allergic diseases may improve management and clinical outcome. The aim of this study was to develop and validate an easy-to-use screening questionnaire to detect children requiring further allergological evaluations. Methods A 10-item questionnaire, evaluating the presence and the history of the most frequent allergic conditions affecting children, including allergic asthma, allergic rhinitis and conjunctivitis, food allergy, and atopic dermatitis, was developed and administered to 214 parents of children from 5 to 10 years of age (163 with allergic disease and 51 healthy, nonallergic children). Validation was performed by Pearson’s correlation between the clinical diagnosis and the responses to the questionnaire. Internal consistency was computed by Cronbach’s alpha correlation coefficient. Sensitivity and specificity of the novel questionnaire were assessed by the receiver operating characteristic (ROC) curve. Results Validation analysis of the new children atopy (ChAt) questionnaire showed good internal consistency with a Cronbach’s alpha of 0.757. Responses to the items evaluating the presence of individual allergic conditions significantly correlated with the clinical diagnosis (p<0.001). The ROC curve showed an area of 0.956 and identified a cutoff value >2 of the ChAt questionnaire total score for detection of allergy (sensitivity =0.92 and specificity =0.902). Conclusion The novel ChAt questionnaire represents a simple tool able to detect the presence of all major allergic diseases in a pediatric population allowing an early identification of allergic multimorbidity and potentially facilitating clinical management.
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Affiliation(s)
- Marta Sacchetti
- Cornea and Ocular Surface Unit, IRCCS-Ospedale San Raffaele di Milano, Milan.,Department of Sense Organs, Sapienza University, Rome
| | - Ilaria Baiardini
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa
| | - Loredana Chini
- Pediatric Allergology and Immunology Unit, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Viviana Moschese
- Pediatric Allergology and Immunology Unit, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
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