New Tool to Predict Childhood Asthma

Ingrid Hein

May 15, 2019

Asthma-prediction tools to date have, by and large, been binary," said Jocelyn Biagini Myers, PhD, from the Cincinnati Children's Hospital Medical Center.

"We wanted a simple, noninvasive tool that was a little more quantitative for families, researchers, and clinicians," she told Medscape Medical News.

Biagini Myers and her colleagues developed the Pediatric Asthma Risk Score (PARS), a free online tool to assess the risk for asthma in young children.

Results from a comparison of the standard Asthma Predicative Index (API) and PARS were recently published in advance of their presentation next week at the American Thoracic Society 2019 International Conference in Dallas (J Allergy Clin Immunol. 2019;143:1803-1810.e2).

Users of PARS answer questions about early wheeze, difficulty breathing when healthy, previous allergy skin testing, race, and parental asthma. The tool then generates a score that indicates whether the risk for asthma is low, moderate, or high, and provides a percentage for the likelihood that the child will develop asthma by the age of 7.

"We took all the factors that we know to be associated with asthma from the literature and narrowed that down to six criteria." Biagini Myers said.

"This offers a more personalized risk than the API," she explained. And the sensitivity of PARS is 11% higher than that of the API, without invasive testing.

Biagini Myers said she hopes the tool will continue to evolve, and could eventually include microbial factors, like mode of birth, and be personalized for specific cohorts. "We did not have any Hispanic or Asian representation in our cohort," she pointed out.

"This could take some of the worry away from some parents. From what I’ve seen, it works better than some of the other scores," said Christine Cole Johnson, PhD, from the Henry Ford Health System in Detroit.

"It's a way to help parents and doctors have a sense of the probability that their child might end up developing asthma; that might resolve in the child being observed more," she pointed out.

"Knowing their risk, they may be able to act early and get interventions, or even medications, as they are made available," Johnson added.

The Children's Respiratory Environmental Workgroup (CREW) is currently bringing together 12 asthma birth cohorts to pool resources (NCT03213184), which the PARS cohort will be participating in. The CREW data will be used to better understand the phenotypes and endotypes of childhood asthma.

The research was funded by the National Institutes of Health. Biagini Myers and Johnson have disclosed no relevant financial relationships.

American Thoracic Society (ATS) 2019 International Conference: Abstract 410. To be presented May 20, 2019.

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