The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers.
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.
Ducharme
Francine M
FM
Clinical Research Group on Childhood Asthma, Department of Pediatrics, McGill University Health Centre, Montreal, Quebec, Canada. francine.ducharme@mcgill.ca
Chalut
Dominic
D
Plotnick
Laurie
L
Savdie
Cheryl
C
Kudirka
Denise
D
Zhang
Xun
X
Meng
Linyan
L
McGillivray
David
D
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
D001993:Bronchodilator Agents; D000420:Albuterol