哮喘联盟

   摘要
   背景：尽管哮喘病情的多方面因素越来越受关注，但按照国家哮喘指南推荐或采用父母报告结果的方式来评估这些因素的小儿哮喘量表很少。
   目的：对一份检测父母报告的哮喘病情多方面因素(方向、烦恼和风险)的量表进行评估。
   方法：我们对常规哮喘护理儿童应用小儿哮喘控制和通信设备（PACCI），并对他们的哮喘控制情况（PACCI控制）、生活质量和肺功能进行评估。评估PACCI的区别效度。
   结果：共317例儿童纳入研究（平均年龄，8.2岁；44%为非裔美国人）。随着父母报告PACCI方向从“变好”到“变差”，我们发现哮喘控制情况降低（P <0 .001）、平均小儿哮喘监护者生活质量问卷（PACQLQ）评分下降(P <0 .001)和FEV1% 下降(P = 0.025)。线性回归分析表明，PACCI方向每变化一次，平均PACQLQ评分下降0.6分 (95% 可信区间, -0.8 to -0.4)。随着父母报告的PACCI烦恼程度从“无烦恼”到“非常烦恼”，我们发现哮喘控制情况降低（P <0 .001）、平均PACQLQ评分下降(P <0.001)。线性回归分析表明，PACCI烦恼分级每改变一级，平均PACQLQ评分下降1.1(95% 可信区间， -1.3 to -0.9)。任何报告的PACCI风险事件（急诊、住院或口服皮质类固醇激素）都与哮喘控制(P <0 .05)和PACQLQ降低有关(P <0 .01)。
   结论：PACCI方向、烦恼程度和风险是评估父母报告结果的可靠指标，并具有很好的区别效度。针对父母报告的哮喘病情、风险和控制等多方面情况，PACCI是一项简单的临床评估工具。
 

（刘国梁 审校）
JAllergyClinImmunolPract.2014Mar-Apr;2(2):186-192.e7.doi:10.1016/j.jaip.2013.10.005. Epub 2014 Jan 17.

 

Validation of parental reports of asthma trajectory, burden, and risk by using the pediatric asthma control and communication instrument.
 

Okelo SO1, Eakin MN2, Riekert KA2, Teodoro AP3, Bilderback AL2, Thompson DA4, Loiaza-Martinez A5, Rand CS2, Thyne S6, Diette GB2, Patino CM7.
 

Abstract
BACKGROUND: Despite a growing interest, few pediatric asthma questionnaires assess multiple dimensions of asthma morbidity, as recommended by national asthma guidelines, or use patient-reported outcomes.
OBJECTIVE: To evaluate a questionnaire that measures multiple dimensions of parent-reported asthma morbidity (Direction, Bother, and Risk).
METHODS: We administered the Pediatric Asthma Control and Communication Instrument (PACCI) and assessed asthma control (PACCI Control), quality of life, and lung function among children who presented for routine asthma care. The PACCI was evaluated for discriminative validity.
RESULTS: A total of 317 children participated (mean age, 8.2 years; 58% boys; 44% African American). As parent-reported PACCI Direction changed from "better" to "worse," we observed poorer asthma control (P < .001), mean Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ) scores (P < .001), and FEV1% (P = .025). Linear regression showed that, for each change in PACCI Direction, the mean PACQLQ score decreased by -0.6 (95% CI, -0.8 to -0.4). As parent-reported PACCI Bother changed from "not bothered" to "very bothered," we observed poorer asthma control (P < .001) and lower mean PACQLQ scores (P < .001). Linear regression showed that, for each change in PACCI Bother category, the mean PACQLQ score decreased by -1.1 (95% CI, -1.3 to -0.9). Any reported PACCI Risk event (emergency department visit, hospitalization, or use of an oral corticosteroid) was associated with poorer asthma control (P < .05) and PACQLQ scores (P < .01).
CONCLUSIONS: PACCI Direction, Bother, and Risk are valid measures of parent-reported outcomes and show good discriminative validity. The PACCI is a simple clinical tool to assess multiple dimensions of parent-reported asthma morbidity, in addition to risk and control.
 

JAllergyClinImmunolPract.2014Mar-Apr;2(2):186-192.e7.doi:10.1016/j.jaip.2013.10.005. Epub 2014 Jan 17.