Longitudinal validation of a tool for asthma self-Monitoring

Flory L. Nkoy, Bryan L. Stone, Bernhard A. Fassl, Derek A. Uchida, Karmella Koopmeiners, Sarah Halbern, Eun H. Kim, Allison Wilcox, Jian Ying, Tom H. Greene, David M. Mosen, Michael N. Schatz, Christopher G Maloney

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 a 0.70) and during follow-ups (Cronbach's a 0.82-0.90). Criterion validity demonstrated a significant correlation between AST and ACQ scores at baseline (r = 20.80, P , .01) and during follow-ups (r = 20.64, 20.72, 20.63, and 20.69). 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. Pediatrics 2013;132:e1554-e1561.

Original languageEnglish (US)
JournalPediatrics
Volume132
Issue number6
DOIs
StatePublished - Jan 1 2013

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Asthma
Symptom Assessment
Odds Ratio
Confidence Intervals
Reproducibility of Results
Adrenal Cortex Hormones
Hospitalization
Cohort Studies
Color
Parents
Prospective Studies
Pediatrics

Keywords

  • Asthma control
  • Pediatrics
  • Self-Management
  • Self-Monitoring

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Nkoy, F. L., Stone, B. L., Fassl, B. A., Uchida, D. A., Koopmeiners, K., Halbern, S., ... Maloney, C. G. (2013). Longitudinal validation of a tool for asthma self-Monitoring. Pediatrics, 132(6). https://doi.org/10.1542/peds.2013-1389

Longitudinal validation of a tool for asthma self-Monitoring. / Nkoy, Flory L.; Stone, Bryan L.; Fassl, Bernhard A.; Uchida, Derek A.; Koopmeiners, Karmella; Halbern, Sarah; Kim, Eun H.; Wilcox, Allison; Ying, Jian; Greene, Tom H.; Mosen, David M.; Schatz, Michael N.; Maloney, Christopher G.

In: Pediatrics, Vol. 132, No. 6, 01.01.2013.

Research output: Contribution to journalArticle

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 2013, 'Longitudinal validation of a tool for asthma self-Monitoring', Pediatrics, vol. 132, no. 6. https://doi.org/10.1542/peds.2013-1389
Nkoy FL, Stone BL, Fassl BA, Uchida DA, Koopmeiners K, Halbern S et al. Longitudinal validation of a tool for asthma self-Monitoring. Pediatrics. 2013 Jan 1;132(6). https://doi.org/10.1542/peds.2013-1389
Nkoy, Flory L. ; Stone, Bryan L. ; Fassl, Bernhard A. ; Uchida, Derek A. ; Koopmeiners, Karmella ; Halbern, Sarah ; Kim, Eun H. ; Wilcox, Allison ; Ying, Jian ; Greene, Tom H. ; Mosen, David M. ; Schatz, Michael N. ; Maloney, Christopher G. / Longitudinal validation of a tool for asthma self-Monitoring. In: Pediatrics. 2013 ; Vol. 132, No. 6.
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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 a 0.70) and during follow-ups (Cronbach's a 0.82-0.90). Criterion validity demonstrated a significant correlation between AST and ACQ scores at baseline (r = 20.80, P , .01) and during follow-ups (r = 20.64, 20.72, 20.63, and 20.69). 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. Pediatrics 2013;132:e1554-e1561.",
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AU - Halbern, Sarah

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