Comparison Of Chinese And International Version Evaluations Of The Test For Respiratory And Asthma Control In Kids(TRACK)

Objectives:Through the treatment and monitoring of wheezing children under 5 years old who are positive for Modified Asthma Predictive Index(m API),follow-up assessment of the level of asthma control in children,and explore the Test for Respiratory and Asthma Control(TRACK))Differences and feasibility between the Chinese version and the international version,and the Global Initiative for Asthma(GINA)in different nebulization intervention programs.Further explore the application value of the Chinese version of TRACK in the management of recurrent wheezing in children under 5 years of age.Methods:The subjects of the study were wheezing cases diagnosed in the First Affiliated Hospital of Nanchang University from March 2018 to March 2020,and met the conditions of 12 months to 59 months and were m API positive.A total of 360 children were included as follow-up subjects.Randomly divided into 3 treatment groups,namely the intermittent high-dose nebulized inhalation BUD group(intermittent high-dose group),the daily nebulized inhalation BUD group(daily group),and the intermittent medium-dose nebulized inhalation BUD group(intermittent medium-dose)Group),120 cases each.In the intermittent high-dose group,when the child had more obvious respiratory symptoms such as cough and runny nose before the onset of wheezing,he started to inhale 1 mg BUD by atomization,twice a day,and stopped the drug after 7 days.In the daily group,aerosol inhalation of 1mg BUD was initiated,once a day,and the condition was evaluated every 4 weeks.After the condition was controlled,the original dose was reduced by 25%-50%,until finally 0.25 mg BUD was inhaled by aerosol,once a day The dose is maintained to 52 weeks,otherwise the original dose will be continued.In the intermittent medium-dose group,once the child has any suspicious respiratory symptoms such as nasal congestion,runny nose,cough or contact with allergens,immediately nebulize 0.5 mg BUD twice a day,and stop the drug for 3 days after the risk factors are removed or the respiratory symptoms completely disappear.Establish follow-up files before the start of the project.After the children are enrolled in the group,the trained staff will teach the family members how to make follow-up records.All enrolled children will be followed up for 52 weeks.Every 4weeks,the trained staff will have asthma according to the GINA standard.The control level evaluates the control level,and completes the Chinese version of the TRACK scoring questionnaire and the international version of the TRACK scoring questionnaire at the same time.Taking the GINA standard control level classification as the "gold standard",through receiver operating characteristic curve(ROC curve)analysis,the best cut-off value for the control classification of wheezing children under 5 years of age who are m API-positive in the Chinese version of TRACK and the international version of the questionnaire was screened.And compare the consistency of the two evaluation methods.Results:1.120 cases in the intermittent high-dose group completed 115 cases,120 cases in the daily group completed 111 cases,and 120 cases in the intermittent medium-dose group completed 117 cases.There was no statistical difference in the completion rate(P>0.05).2.After treatment,the score control rate of TRACK Chinese version and international version of the three groups of children were significantly higher than before treatment(P<0.05).3.In the intermittent high-dose group,the score control rate of the TRACK Chinese version from 4 to 52 weeks was lower than that of the international version,and the difference was significant(P<0.05),the consistency was 75.2%,and the Kappa was 0.426.4.The score control rate of the Chinese version of TRACK in the daily group and the intermittent medium-dose group was lower than that of the international version in 4 and 8 weeks,and the difference was significant(P<0.05).The score control rate of the Chinese version and the international version of TRACK from 12 weeks to 52 weeks was significant.The difference was not significant(P>0.05),the agreement was 93.2% and 92.9%,and the Kappa was 0.777 and 0.760,respectively.5.The consistency of the three groups in the Chinese version of TRACK and GINA was 68.4%,83.1%,and 82.2%,respectively,and the kappa was 0.257,0.401,and 0.360,respectively.6.The consistency of the three international versions of TRACK and GINA were88.6%,88.0%,89.1%,and the kappa values were 0.488,0.509,0.509,respectively.7.The area under the ROC curve of the Chinese version of TRACK for diagnosis of asthma control is 0.877,the best cut-off value is 75 points,the sensitivity is 78.1%,and the specificity is 76.2%.8.The area under the ROC curve of the international TRACK diagnosis of asthma control is 0.897,the best cut-off value is 80 points,the sensitivity is 76.0%,and the specificity is 75.2%.Conclusion:1.The Chinese version of TRACK and the international version maintain a high degree of consistency in the daily group and the intermittent medium-dose group,which can be used as an effective assessment tool to help monitor and manage the condition of wheezing children under 5 years of age.2.The Chinese version of TRACK has stricter control levels for wheezing children than the international version.The clinical application should be combined with the intervention methods used by wheezing children.At the same time,attention should be paid to the potential risks of using high-dose inhaled corticosteroids.3.The three treatment options can significantly improve the score control rate of TRACK Chinese version and international version for children under 5 years of age,suggesting that intermittent medium-dose aerosol inhalation BUD can be used as a m API-positive recurrent wheezing children under 5 years of age.One of the prevention and treatment programs.