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Asthma Flare-up Diary for Young Children to monitor the severity of exacerbations.
- Source :
- Journal of Allergy & Clinical Immunology; Mar2016, Vol. 137 Issue 3, p744-749.e6, 1p
- Publication Year :
- 2016
-
Abstract
- Background Few instruments exist to ascertain the severity of a preschool-aged child's asthma exacerbations managed at home. Objective We sought to develop and validate a functional status instrument to assess asthma exacerbation severity in preschoolers. Methods The parent-completed Asthma Flare-up Diary for Young Children (ADYC), which was developed systematically, comprises 17 items, each scored from 1 (best) to 7 (worst). The ADYC was completed daily from the onset of an upper respiratory tract infection (URTI) until asthma symptom resolution; the cumulative daily score was reported. The ADYC was examined for key psychometric properties in a randomized placebo-controlled trial of pre-emptive high-dose fluticasone in preschoolers with URTI-induced asthma. Results In 121 children aged 2.7 ± 1.1 years (59.5% male), the ADYC's internal consistency (Cronbach α = .97), feasibility (97% completion), and test-retest reliability ( r = 0.71; 95% CI, 0.59-0.80) were demonstrated. The ADYC was responsive to change between 2 consecutive days (Guyatt statistic = 0.77) with a minimal important difference of 0.22 (0.17-0.27). Of 871 episodes, the cumulative ADYC score was significantly higher during exacerbations than during URTIs (mean difference [MD], 7.6; 95% CI, 6.4-8.9) and for exacerbations with an acute-care visit (MD, 9.1; 95% CI, 7.6-10.7), systemic corticosteroids (MD, 10.1; 95% CI, 8.3-12.0), and hospitalization (MD, 6.8; 95% CI, 2.9-10.7) versus those without. In children receiving fluticasone, the ADYC score was significantly lower versus that in the placebo group (MD, 5.1; 95% CI, 1.8-8.3). Conclusions The 17-item ADYC proved feasible, responsive to day-to-day changes, and discriminative across exacerbations of different severities. In a trial testing effective therapy in preschoolers, it identified a significant reduction in asthma exacerbation severity. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00916749
- Volume :
- 137
- Issue :
- 3
- Database :
- Supplemental Index
- Journal :
- Journal of Allergy & Clinical Immunology
- Publication Type :
- Academic Journal
- Accession number :
- 113427477
- Full Text :
- https://doi.org/10.1016/j.jaci.2015.07.028