title: The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers.
abstract: OBJECTIVE
  To determine the performance characteristics of the Preschool Respiratory Assessment Measure (PRAM) in preschool and school-aged children with acute asthma.
  
  
  METHODS
  In a prospective cohort study, we examined the validity, responsiveness, and reliability of the PRAM in children aged 2 to 17 years with acute asthma. The study involved more than 100 nurses and physicians who recorded the PRAM on triage, after initial bronchodilation, and at disposition. Predictive validity and responsiveness were examined using disposition as outcome.
  
  
  RESULTS
  The PRAM was recorded in 81% (n = 782) of patients at triage. The PRAM at triage and after initial bronchodilation showed a strong association with admission (r = 0.4 and 0.5, respectively; P < .0001), thus supporting its ability to distinguish across severity levels. The responsiveness coefficient of 0.7 indicated good ability to identify change after bronchodilation. The PRAM showed good internal consistency (Cronbach alpha = 0.71) and inter-rater reliability (r = 0.78) for all patients and across all age groups.
  
  
  CONCLUSIONS
  Good performance characteristics were observed in all age groups, making the PRAM an attractive score for assessing asthma severity and response to treatment.
authors.affiliation: Clinical Research Group on Childhood Asthma, Department of Pediatrics, McGill University Health Centre, Montreal, Quebec, Canada. francine.ducharme@mcgill.ca
authors.forename: Francine M
authors.initials: FM
authors.lastname: Ducharme
authors.forename: Dominic
authors.initials: D
authors.lastname: Chalut
authors.forename: Laurie
authors.initials: L
authors.lastname: Plotnick
authors.forename: Cheryl
authors.initials: C
authors.lastname: Savdie
authors.forename: Denise
authors.initials: D
authors.lastname: Kudirka
authors.forename: Xun
authors.initials: X
authors.lastname: Zhang
authors.forename: Linyan
authors.initials: L
authors.lastname: Meng
authors.forename: David
authors.initials: D
authors.lastname: McGillivray
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000420:Albuterol / Q000627:therapeutic use; D001249:Asthma / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol