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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.

ABSTRACT: OBJECTIVE:The 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 English version of the Test for Respiratory and Asthma Control in Kids (TRACK) was translated into Chinese and validated for its application in asthma control in preschool children. DESIGN:Prospective validation study. SETTING AND PARTICIPANTS:A total of 321 Chinese preschool children suffering from asthma completed the study from December 2017 to February 2018. METHOD:The TRACK translation into Chinese employed the translation and back translation technique. The caregivers of the preschool children with asthma symptoms completed TRACK during two clinical visits over 4-6 weeks. Moreover, the physicians completed a Global Initiative for Asthma (GINA)-based asthma control survey at both visits. The utility of TRACK for assessing the change in asthma control status and its reliability and discriminant validity were evaluated. RESULTS:The Chinese version of TRACK showed internal consistency reliability values of 0.63 and 0.71 at each visit, respectively (Cronbach's ?). The test-retest reliability was 0.62 for individuals whose GINA-based assessment results were the same at both visits (n=206). The TRACK scores for the children in the various asthma control categories were significantly different (p<0.001). Children recommended for increased treatment by the physicians had lower TRACK scores than those recommended for no change in treatment or decreased treatment (p<0.001). CONCLUSION:The study verifies the validity and reliability of the Chinese version of TRACK. Changes in the TRACK scores effectively reflected the level of asthma control in preschool children and guided further treatment strategies. TRIAL REGISTRATION NUMBER:NCT02649803.

SUBMITTER: Zhang J

PROVIDER: S-EPMC6720147 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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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.

Zhang Jing J Zhao Liebin L Zhao Deyu D Chen Zhimin Z Li Shenghui S Zhang Hao H Zhang Lei L Yuan ShuHua S Tang Mingyu M Wu YuFen Y Zhong Wenwei W Xu Juan J Zhao Li Xia LX Liu Shi Ying SY Hong Jianguo J Yin Yong Y

BMJ open 20190826 8

<h4>Objective</h4>The 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 English version of the Test for Respiratory and Asthma Control in Kids (TRACK) was translated into Chinese and validated for its application in asthma control in preschool children.<h4>Design</h4>Prospective validation study.<h4>Setting and participants</h4>A total of 321 Chinese preschool chi ...[more]

PMID: 31455696

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Project description:BackgroundTRACK (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.ObjectiveTo validate the Portuguese version of the TRACK questionnaire.MethodsThe 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.ResultsData 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).ConclusionWe 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 registrationClinicalTrials.gov: NCT03290222.

Project description:Dyspnea is a common, distressing symptom of cardiopulmonary and neuromuscular diseases and is defined as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity." However, Japanese intensive care units (ICUs) do not routinely screen for dyspnea, as no validated Japanese version of the Respiratory Distress Observation Scale (RDOS) is available. Therefore, we aimed to translate the English version of this questionnaire into Japanese and assess its validity and reliability. To translate the RDOS, we conducted a prospective observational study in a 12-bed ICU of a universal hospital that included 42 healthcare professionals, 10 expert panels, and 128 ventilated patients. The English version was translated into Japanese, and several cross-sectional web-based questionnaires were administered to the healthcare professionals. After completing the translation process, a validity and reliability evaluation was performed in the ventilated patients. Inter-rater reliability was evaluated using Cohen's weighted kappa coefficient. Criterion validity was ascertained based on the correlation between RDOS and the dyspnea visual analog scale. The area under the receiver operating characteristic curve analysis was used to evaluate the ability of the RDOS to identify patients with self-reported dyspnea. The average content validity index at the scale level was 0.95. Data from the 128 patients were collected and analyzed. Cohen's weighted kappa coefficient and the correlation coefficient between the two scales were 0.76 and 0.443 (95% confidence intervals 0.70-0.82 and 0.23-0.62), respectively. For predicting self-reported dyspnea, the area under the receiver operating characteristic curve was 0.81 (95% confidence interval 0.67-0.97). The optimal cutoff used was 1, with a sensitivity and specificity of 0.89 and 0.61, respectively. Our findings indicated that the Japanese version of the RDOS is acceptable for face validity, understandability, criterion validity, and inter-rater reliability in lightly sedated mechanically ventilated patients, indicating its clinical utility.

Project description:BackgroundThe evaluation of respiratory system health status in hospitalized patients is usually based on many laboratory examinations and imaging examinations. Medical examinations require a lot of manpower, material resources, financial resources, and may cause a certain degree of mechanical damage and radiation damage. It is not easily used widely and economically to assess the respiratory health status of community adults. Therefore, researchers developed a brief adult respiratory system health status scale-community version (BARSHSS-CV) and tested its reliability and validity.MethodsUsing clinical characteristics and pathogenic factors of respiratory system diseases as a theoretical basis and through reference to relevant literature, researchers developed an initial scale. A randomized cluster sampling strategy was used to recruit adults in the communities of Baoding City, Shijiazhuang City, Cangzhou city and Chifeng City in China. Researchers randomly selected 1 district from each city. Subsequently, 4 communities were respectively randomly selected from 4 districts. Then, researchers conducted the questionnaire survey in 4 communities. Finally, researchers investigated 615 community adults. 584 valid questionnaires were recovered. By applying exploratory factor analysis, confirmatory factor analysis, content validity index, Cronbach's ? coefficient, mean inter-item correlation coefficient and test-retest reliability, researchers tested the reliability and validity of scale and created the final BARSHSS-CV.ResultsBARSHSS-CV Cronbach's ?=0.951, content validity?=?0.933, test-retest reliability?=?0.963 and factor cumulative contribution rate?=?67.168% by exploratory factor analysis. By confirmatory factor analysis, Chi square value (?2) was 442.117, degrees of freedom (df) was 161, Chi square value/degrees of freedom (?2 /df) was 2.746, root-mean-square error of approximation (RMSEA) was 0.065, goodness of fit index (GFI) was 0.902, incremental fit index (IFI) was 0.955, comparative fit index (CFI) was 0.955, normed fit index (NFI) was 0.931, Tueker-Lewis index (TLI) was 0.947. BARSHSS-CV consisted of 20 items and 3 dimensions.ConclusionsBARSHSS-CV with good test-retest reliability and content/construct validity is a brief and economical tool for assessing the state of respiratory system amongst adult communities. BARSHSS-CV may help medical staff in community primary medical institutions quickly, conveniently and economically assess the status of respiratory system and the main problems of respiratory system in community adults.

Project description:ObjectiveTo adapt the Appropriateness Evaluation Protocol (AEP) to the specific settings of health care in China and to validate the Chinese version AEP (C-AEP).MethodsForward and backward translations were carried out to the original criteria. Twenty experts participated in the consultancy to form a preliminary version of the C-AEP. To ensure applicability, tests of reliability and validity were performed on 350 admissions and 3,226 hospital days of acute myocardial infraction patients and total hip replacement patients in two tertiary hospitals by two C-AEP reviewers and two physician reviewers. Overall agreement, specific agreement, and Cohen's Kappa were calculated to compare the concordance of decisions between pairs of reviewers to test inter-rater reliability and convergent validity. The use of "overrides" and opinions of experts were recorded as measurements of content validity. Face validity was tested through collecting perspectives of nonprofessionals. Sensitivity, specificity, and predictive values were also reported.ResultsThere are 14 admission and 24 days of care criteria in the initial version of C-AEP. Kappa coefficients indicate substantial agreement between reviewers: with regard to inter-rater reliability, Kappa (κ) coefficients are 0.746 (95% confidence interval [CI] 0.644-0.834) and 0.743 (95% CI 0.698-0.767) of admission and hospital days, respectively; for convergent validity, the κ statistics are 0.678 (95% CI 0.567-0.778) and 0.691 (95% CI 0.644-0.717), respectively. Overrides account for less than 2% of all judgments. Content validity and face validity were confirmed by experts and nonprofessionals, respectively. According to the C-AEP reviewers, 18.3% of admissions and 28.5% of inpatient days were deemed inappropriate.ConclusionsThe C-AEP is a reliable and valid screening tool in China's tertiary hospitals. The prevalence of inappropriateness is substantial in our research. To reduce inappropriate utilization, further investigation is needed to elucidate the reasons and risk factors for this inappropriateness.

Dataset Information

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.

Publications

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.

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