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Published on: August 7, 2017

Predicting asthma in preschool children with asthma-like symptoms: validating and updating the PIAMA risk score

Esther Hafkamp-de Groen1, Hester F Lingsma, Daan Caudri

  • 1Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.

The Journal of Allergy and Clinical Immunology
|August 31, 2013
PubMed

Insights

The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) risk score accurately predicts childhood asthma across diverse groups. An updated version shows similar predictive power, confirming its generalizability.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Epidemiology

Background:

  • The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) risk score aids in predicting childhood asthma.
  • Validating and updating this score is crucial for diverse populations.

Purpose of the Study:

  • To externally validate the PIAMA risk score in a multiethnic cohort.
  • To assess the score's performance across different ages and socioeconomic/ethnic subgroups.
  • To update the PIAMA risk score and evaluate its improved predictive ability.

Main Methods:

  • A prospective, population-based cohort study (Generation R) of 2877 children with preschool asthma-like symptoms.
  • Assessed PIAMA risk score at preschool age, predicting asthma at age 6.
  • Evaluated discrimination (C-index) and calibration; updated the score and re-analyzed performance.

Main Results:

  • Asthma prevalence at age 6 was 6%.
  • Original PIAMA score showed good discriminative ability (C-index=0.74), similar to the original cohort.
  • The score performed consistently across age, ethnic, and socioeconomic subgroups; updated score achieved C-index=0.75.

Conclusions:

  • The PIAMA risk score demonstrates strong external validity and generalizability.
  • Its predictive performance is consistent across diverse pediatric populations.
  • Further research is needed to confirm the updated score's clinical utility and reproducibility.
Abstract

Keywords:
AsthmaC-indexConcordance indexLR+LR−Likelihood ratio of a negative test resultLikelihood ratio of a positive test resultNPVNegative predictive valueOROdds ratioPIAMAPPVPositive predictive valuePrevention and Incidence of Asthma and Mite AllergyPrevention and Incidence of Asthma and Mite Allergy risk scorebirth cohortchildrenexternal validationpredictionprognosisupdatingwheeze

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