title: Modified pulmonary index score was sufficiently reliable to assess the severity of acute asthma exacerbations in children.
abstract: BACKGROUND
  The Modified Pulmonary Index Score (MPIS) was developed as an indicator of the severity of acute asthma in children. The objective of this study is to evaluate the reliability and validity of the MPIS for children with acute asthma, including those five years or younger in age.
  
  
  METHODS
  We evaluated the inter-rater reliability and internal consistency of the MPIS by having at least two trained physicians and a nurse-each of whom was blinded to the others' scores-simultaneously examine inpatients with asthma exacerbation and rate them according to the MPIS. We also evaluated the intraclass correlation coefficient (ICC), kappa, Cronbach's α and correlations between the MPIS and other indicators associated with asthma severity.
  
  
  RESULTS
  A total of 25 children (median age, five years; 13 patients were five years or younger in age) were enrolled in this study. The MPIS showed excellent inter-rater reliability (all ages: ICC = 0.95, 95% CI = 0.94-0.97; five years or younger: ICC = 0.93, 95% CI = 0.89-0.96) and good internal consistency (all ages: Cronbach's α = 0.87; five years or younger: Cronbach's α = 0.85). The MPIS showed good correlation with a visual analogue scale assessed by the physicians.
  
  
  CONCLUSIONS
  The MPIS was a sufficiently reliable assessment tool for children with acute asthma, including those five years or younger in age.
authors.affiliation: Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Maekawa
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan.
authors.forename: Mari S
authors.initials: MS
authors.lastname: Oba
authors.affiliation: Department of Pediatrics, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Katsunuma
authors.affiliation: Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ishiguro
authors.affiliation: Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Ohya
authors.affiliation: Division for Clinical Trials, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D001249:Asthma / Q000097:blood / Q000175:diagnosis*; D001784:Blood Gas Analysis; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006339:Heart Rate; D006801:Humans; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D056152:Respiratory Rate; D012135:Respiratory Sounds; D012720:Severity of Illness Index