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Reliability and validity of the Chinese version of the Test for Respiratory and Asthma Control in Kids (TRACK) in preschool children with asthma: a prospective validation study
  1. Jing Zhang1,
  2. Liebin Zhao1,
  3. Deyu Zhao2,
  4. Zhimin Chen3,
  5. Shenghui Li4,
  6. Hao Zhang1,
  7. Lei Zhang1,5,
  8. ShuHua Yuan1,
  9. Mingyu Tang1,
  10. YuFen Wu1,
  11. Wenwei Zhong1,
  12. Juan Xu1,
  13. Li Xia Zhao1,
  14. Shi Ying Liu1,
  15. Jianguo Hong6,
  16. Yong Yin1
  1. 1Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
  2. 2Respiratory Medicine, Nanjing Children’s Hospital, Nanjing Medical University, Nanjing, China
  3. 3Respiratory Medicine, The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
  4. 4School of Public Health, Shanghai Jiao Tong University, Shanghai, China
  5. 5Pediatrics, Shanghai Pudong District People’s Hospital, Shanghai, China
  6. 6Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
  1. Correspondence to Professor Jianguo Hong; hongjianguo{at}


Objective The limited existing asthma control questionnaires that are available for children 5 years of age or younger in China mostly assess only the impairment domain of asthma control. Here, the English version of the Test for Respiratory and Asthma Control in Kids (TRACK) was translated into Chinese and validated for its application in asthma control in preschool children.

Design Prospective validation study.

Setting and participants A total of 321 Chinese preschool children suffering from asthma completed the study from December 2017 to February 2018.

Method The TRACK translation into Chinese employed the translation and back translation technique. The caregivers of the preschool children with asthma symptoms completed TRACK during two clinical visits over 4–6 weeks. Moreover, the physicians completed a Global Initiative for Asthma (GINA)-based asthma control survey at both visits. The utility of TRACK for assessing the change in asthma control status and its reliability and discriminant validity were evaluated.

Results The Chinese version of TRACK showed internal consistency reliability values of 0.63 and 0.71 at each visit, respectively (Cronbach’s α). The test–retest reliability was 0.62 for individuals whose GINA-based assessment results were the same at both visits (n=206). The TRACK scores for the children in the various asthma control categories were significantly different (p<0.001). Children recommended for increased treatment by the physicians had lower TRACK scores than those recommended for no change in treatment or decreased treatment (p<0.001).

Conclusion The study verifies the validity and reliability of the Chinese version of TRACK. Changes in the TRACK scores effectively reflected the level of asthma control in preschool children and guided further treatment strategies.

Trial registration number NCT02649803

  • asthma
  • asthma control
  • preschool children
  • questionnaire
  • reliability
  • validity

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  • Contributors JGH, YY and LBZ contributed to the conception and design of the study, revising the draft critically for important intellectual content. JZ and SHL contributed to the data analysis and drafting of the submitted article. JGH and JZ contributed to the translation, data acquisition and interpretation of the outcomes. JGH and YY contributed to the crucial revision of the draft for important intellectual content, provided final confirmation of the revised version to be published and obtained permission to use the original questionnaire. DYZ, ZMC, HZ, JZ, LZ, SHY, MYT, YFW, WWZ, JX, LXZ, SYL and LZ contributed to the follow-up of patients and extracting and analysing the data. All authors contributed to the data analysis, drafting the manuscript and amending the paper and all take responsibility for all aspects of the work. All the data were accessible to all the authors to ensure the accuracy of the reported data.

  • Funding This study was funded by AstraZeneca China, the Shanghai Shen Kang Hospital Development Center’s Appropriate Technology Joint Development and Popularization Project 'The promotion of nebulization technology based on the standardized management of asthma in family and community for children' (no. SHDC12016216) and the Shanghai Shen Kang Hospital Development Center Projects for the Prevention and Control of Chronic Disease (no. SHDC12015306). It was also funded by the key projects of the Shanghai Science and Technology Department of Medicine (no. 16411955100), the Three-Year Action Plan to Promote Clinical Skills and Clinical Innovation Capability in Municipal Hospitals (no. 16CR4002A), the Discipline Construction of Nursing Plateau (no. hlgy16030kyg8), the Study on Schema Design for Enhancing the Compliance of ICS in Asthmatic Children Based on an Information Platform (no. jyh1519), the Important Weak Discipline of Shanghai Health and Family Planning Commission⁠—Pediatrics (no. 2016ZB0104), the Shanghai Pudong New Area Municipal Planning Commission of Science and Research Fund (no. PW2017E-1), Projects for the construction of important and weak subjects in the health system of Pudong District (no. PWZbr2017-25) and the Key Project of China Hospital Development Institute of Shanghai Jiaotong University (CHDI-2017-A-06).

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Ethics approval Ethical approval for the study was granted by the Shanghai General Hospital Research Ethics Committee (2018KY001) and Shanghai Children’s Medical Center Research Ethics Committee (SCMCIRB-K2016037).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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