TRACK as a complementary tool to GINA and NAEPP guidelines for assessing asthma control in pre-school children.
BACKGROUND
In this study, our goal is to evaluate the consistency between TRACK and the asthma control levels assessed according to the GINA and NAEPP guidelines in children younger than 5 years of age.


METHODS
Patients under 5 years old, who were followed up for recurrent wheezing for at least 1 year have been included. Parents were given the TRACK questionnaire and the control level of asthma according to GINA and NAEPP guidelines were determined by a pediatric allergist blinded to TRACK scores. Patients were classified into two groups regarding the compatibility of the control level between TRACK and both GINA and NAEPP guidelines.


RESULTS
A total of 365 questionnaires were evaluated. The TRACK cut-off point of 80 provided the most consistent balance between sensitivity and specificity for the compatibility with both GINA and NAEPP (for GINA 0.763 and 0.663, kappa = 0.487, p < 0.001 and for NAEPP 0.761 and 0.769, kappa = 0.524, p < 0.001, respectively). When 80 was taken as the cut-off value for TRACK, the compatibility rate of asthma control levels between TRACK and GINA and TRACK and NAEPP was 71.0 and 76.4%, respectively. About 70.1% of the patients who had TRACK scores over 80 and had mild asthma were grouped as controlled according to GINA and 50.0% of patients who had TRACK scores over 80 and had moderate to severe asthma was grouped as uncontrolled according to GINA (p = 0.019).


CONCLUSIONS
TRACK is compatible with NAEPP and GINA in majority of asthmatic children under 5 years of age. Nevertheless, there is a discrepancy between guidelines and TRACK scores; therefore, it should be used in conjunction with a detailed clinical examination in order to make a better decision for assessing the control levels and management plan.
Ankara Children's Hematology Oncology Education and Research Hospital, Pediatric Allergy Department , Altındağ, Ankara , Turkey.
Ayşenur
A
Kaya
Mustafa
M
Erkocoglu
Aysegul
A
Akan
Emine
E
Vezir
Dilek
D
Azkur
Celal
C
Ozcan
Ersoy
E
Civelek
Muge
M
Toyran
Tayfur
T
Giniş
Emine Dibek
ED
Misirlioglu
Can Naci
CN
Kocabas
D001249:Asthma / Q000175:diagnosis* / Q000517:prevention & control*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D012574:Schools; D011795:Surveys and Questionnaires
Asthma control; GINA; NAEPP; TRACK; pre-school children