title: Clinical Scores for Dyspnoea Severity in Children: A Prospective Validation Study.
abstract: BACKGROUND
  In acute dyspnoeic children, assessment of dyspnoea severity and treatment response is frequently based on clinical dyspnoea scores. Our study aim was to validate five commonly used paediatric dyspnoea scores.
  
  
  METHODS
  Fifty children aged 0-8 years with acute dyspnoea were clinically assessed before and after bronchodilator treatment, a subset of 27 children were videotaped and assessed twice by nine observers. The observers scored clinical signs necessary to calculate the Asthma Score (AS), Asthma Severity Score (ASS), Clinical Asthma Evaluation Score 2 (CAES-2), Pediatric Respiratory Assessment Measure (PRAM) and respiratory rate, accessory muscle use, decreased breath sounds (RAD).
  
  
  RESULTS
  A total of 1120 observations were used to assess fourteen measurement properties within domains of validity, reliability and utility. All five dyspnoea scores showed overall poor results, scoring insufficiently on more than half of the quality criteria for measurement properties. The AS and PRAM were the most valid with good values on six and moderate values on three properties. Poor results were mainly due to insufficient measurement properties in the validity and reliability domains whereas utility properties were moderate to good in all scores.
  
  
  CONCLUSIONS
  This study shows that commonly used dyspnoea scores show insufficient validity and reliability to allow for clinical use without caution.
authors.affiliation: Princess Amalia Children's Clinic, Isala, Zwolle, the Netherlands.|University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Hendriekje
authors.initials: H
authors.lastname: Eggink
authors.affiliation: Princess Amalia Children's Clinic, Isala, Zwolle, the Netherlands.|University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Brand
authors.affiliation: Princess Amalia Children's Clinic, Isala, Zwolle, the Netherlands.
authors.forename: Roelien
authors.initials: R
authors.lastname: Reimink
authors.affiliation: Princess Amalia Children's Clinic, Isala, Zwolle, the Netherlands.
authors.forename: Jolita
authors.initials: J
authors.lastname: Bekhof
mesh_terms: D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004417:Dyspnea / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D015272:Pulmonary Medicine / Q000592:standards; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014741:Video Recording
chemical_list: D001993:Bronchodilator Agents