Objective: To assess the agreement of a self-completed diary to monitor respiratory symptoms in children aged 6-12 years with parental symptom reports and fluctuations in lung function.
Design: We created a text- and symbol-based questionnaire for daily completion by children at school. Using a screening questionnaire completed by the parents, we selected 101 children with lower respiratory symptoms in the last year or doctor-diagnosed asthma to complete the diary. We assessed the agreement with a parent-completed daily symptom diary and measurements of peak expiratory flow (PEF) over 5 weeks, estimating % agreement and the kappa statistic (kappa) for pairwise comparisons.
Results: Simple agreement between PEF variability, parent-reported and child-reported symptoms was moderate to high. Using kappa, agreement between children's and parents' reports of respiratory symptoms was only fair to moderate, and agreement with lung function measurements was poor for both parent- and child-reported symptoms.
Conclusion: Agreement between children's and parents' reports on day-to-day respiratory symptoms was fair to moderate. The children's symptom diary agreed poorly with lung function measurements, but was neither worse nor better than the parent-completed diary.