Validation of the Brief Pediatric Asthma Screen.
OBJECTIVE
The purpose of this study was to confirm the validity of a brief screen for pediatric asthma in schools.


BACKGROUND
Asthma is the most common chronic disease of childhood, yet the frequency with which this condition is recognized among school-aged children varies widely. Several methods are used to increase the accuracy of detection of asthma, but many are cumbersome and difficult to apply on a large scale.


METHODS
We elected to validate a five-question instrument, the Brief Pediatric Asthma Screen (BPAS), to screen for the presence of asthma among children attending school in Region 5 of the Chicago school district, where the schools report a 2.7% frequency of asthma. The questionnaire was distributed to the parents of grade-school children at the time of report-card pick-up.


METHODS
A clinical assessment was performed on a selected group of children whose parents completed the questionnaire in a school and in a hospital outpatient clinic.


METHODS
Of 4,147 questionnaires that we distributed, 1,796 (43%) were returned. We excluded 341 children (19% of the total sample) whose parents reported that they had been diagnosed with asthma. The remaining pool indicated that the children of 183 responders (10%) had symptoms suggestive of asthma, while 1,272 parents (71%) indicated that their children did not have symptoms of asthma.


RESULTS
We selected 90 of the respondents who did not indicate that their children had a diagnosis of asthma. Of this group, 81 completed the validation, in which their responses suggested symptoms of asthma (n = 34) or no asthma symptoms (n = 47). The children of these respondents were given a blinded clinical evaluation consisting of history, physical examination, and spirometry. The survey demonstrated a sensitivity of 75% and a specificity of 81.2% for the presence of asthma among those who were unaware of the diagnosis.


CONCLUSIONS
The BPAS is brief, can be filled out by parents, and appears accurate in detecting asthma.
Wolf
R L
RL
La Rabida Children's Hospital and Research Center, Chicago, IL 60649, USA. rlwolf@midway.uchicago.edu
Berry
C A
CA
O'Connor
T
T
Coover
L
L
D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D002641:Chicago; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D012307:Risk Factors; D012572:School Health Services; D011795:Surveys and Questionnaires; D014504:Urban Health