PARS- A new tool to predict childhood asthma

Cincinnati, Ohio: The researchers have developed the Pediatric Asthma Risk Score (PARS) -- a free online tool to predict asthma in young children.

The study, published in The Journal of Allergy and Clinical Immunology, found that PARS performed better than the Asthma Predictive Index (API) in children with mild-to-moderate asthma. Results will also be presented at the American Thoracic Society 2019 International Conference in Dallas.

This is significant as children with mild to moderate asthma are most difficult to predict and if predicted early can aid in easy prevention of the disease.

"Currently, asthma is not amenable to primary prevention or early intervention due to difficulty in predicting its natural history," write the authors. "Due to the lack of better alternatives, clinicians remain reliant on poorly predictive asthma outcome tools."

Jocelyn M. Biagini Myers, Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, and colleagues sought to develop a quantitative personalized tool to predict asthma development in young children.

Users of PARS answer questions about early wheeze, difficulty breathing when healthy, previous allergy skin testing, race, and parental asthma. The tool then generates a score that indicates whether the risk for asthma is low, moderate, or high, and provides a percentage for the likelihood that the child will develop asthma by the age of 7.

For the study, the researchers used data from the Cincinnati Childhood Allergy and Air Pollution Study (n = 762) birth cohort to identify factors that predicted asthma development. PARS was constructed by integrating demographic and clinical data. The sensitivity and specificity of PARS were compared with those of the API and replicated in the Isle of Wight birth cohort.

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The researchers found that:

• PARS reliably predicted asthma development in the Cincinnati Childhood Allergy and Air Pollution Study (sensitivity = 0.68, specificity = 0.77).


• Although both the PARS and API predicted asthma in high-risk children, the PARS had improved the ability to predict asthma in children with mild-to-moderate asthma risk.


• In addition to parental asthma, eczema, and wheezing apart from colds, variables that predicted asthma in the PARS included early wheezing, sensitization to 2 or more food allergens and/or aeroallergens, and African American race.


• The PARS was replicated in the Isle of Wight birth cohort (sensitivity = 0.67, specificity = 0.79), demonstrating that it is a robust, valid, and generalizable asthma predictive tool.

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"It's a way to help parents and doctors have a sense of the probability that their child might end up developing asthma; that might resolve in the child being observed more," write the authors. "Knowing their risk, they may be able to act early and get interventions, or even medications, as they are made available.

For detailed study log on to https://doi.org/10.1016/j.jaci.2018.09.037