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Development and initial testing of Asthma Predictive Index for a retrospective study: an exploratory study

Chung-Il Wi1, Miguel A Park, Young J Juhn

  • 1Department of Pediatric and Adolescent Medicine .

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|August 27, 2014
PubMed

Insights

The Asthma Predictive Index (API) can be effectively used in retrospective studies to determine asthma status. This validation supports its retrospective application, identifying key risk factors for childhood asthma.

Area of Science:

  • Pediatric Pulmonology
  • Epidemiology
  • Clinical Research Methodology

Background:

  • The Asthma Predictive Index (API) is established for prospective asthma prediction.
  • Its utility in retrospective studies for diagnosing asthma has not been previously validated.
  • Retrospective cohort studies often require reliable methods for assessing historical disease status.

Purpose of the Study:

  • To develop and validate a modified Asthma Predictive Index (API) suitable for retrospective asthma diagnosis.
  • To assess the criterion and construct validity of the retrospective API.

Main Methods:

  • A cross-sectional study utilizing data from a prior retrospective cohort.
  • Operationalized retrospective API using wheezing episodes and original API criteria.
  • Assessed validity against Predetermined Asthma Criteria (PAC) using kappa statistics and agreement rates.
  • Examined associations between the retrospective API and known asthma risk factors.

Main Results:

  • The study included 105 children (52.4% male, 85.7% Caucasian, mean age 5.8 years).
  • Retrospective API identified 14.3% of children with asthma, while PAC identified 31.4%.
  • High agreement (89.5%) and significant kappa (0.66, p<0.01) were found between retrospective API and PAC.
  • Atopy, lower parental education, no breastfeeding, and family history of asthma were significant risk factors.

Conclusions:

  • The modified Asthma Predictive Index (API) is suitable for ascertaining asthma status in retrospective studies.
  • Findings suggest the retrospective API is a valid tool for asthma assessment.
  • Further validation with larger sample sizes is recommended.
Abstract

Keywords:
Asthma ascertainmentPredetermined asthma criteriaasthma predictive indexretrospective studywheezing

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