A simple tool to identify infants at high risk of mild to severe childhood asthma: the persistent asthma predictive score.
BACKGROUND
Recurrent wheezing in infants is a recognized risk factor for the development of childhood asthma. We sought to develop an easy-to-use persistent asthma predictive score (PAPS) in a population of young recurrent wheezers.


METHODS
We retrospectively studied clinical and biological data of infants under 2 years of age presenting recurrent wheezing and evaluated current asthma at 6 years of age using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Multivariate analysis was performed to select predictive variables to generate a PAPS. The score was then tested on another cohort for independent validation.


RESULTS
Two hundred infants were included in the cohort used to create the PAPS, and 227 in the validation cohort. In the first population, 47% of the children had developed asthma at 6 years of age, including 33% with mild to severe persistent asthma. Three parameters independently predicted persistent asthma: family history of asthma, personal atopic dermatitis, and multiple allergen sensitizations. Based on these variables, the PAPS showed 42% sensitivity, 90% specificity, 67% positive predictive value, and 76% negative predictive value for the prediction of persistent asthma. It was able to discriminate future persistent asthmatic from nonfuture persistent asthmatic children, with an accuracy of 74% in the initial population and 67% in the validation population.


CONCLUSIONS
The PAPS, based on three easy-to-obtain variables, could help the physician in clinical practice to identify infants at high risk for persistent childhood asthma, and thus better evaluate the need for secondary preventive measures.
Centre de l'Asthme et des Allergies, Groupe Hospitalier Trousseau-La Roche Guyon, Assistance Publique - Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, Paris, France.
Amandine
A
Vial Dupuy
Flore
F
Amat
Bruno
B
Pereira
André
A
Labbe
Jocelyne
J
Just
D001249:Asthma / Q000175:diagnosis* / Q000235:genetics; D001772:Blood Cell Count; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000175:diagnosis; D005512:Food Hypersensitivity / Q000175:diagnosis; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007159:Immunologic Tests; D007223:Infant; D011336:Probability; D012135:Respiratory Sounds; D012307:Risk Factors; D011795:Surveys and Questionnaires
D007073:Immunoglobulin E