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Asthma predictive index as a useful diagnostic tool in preschool children: a cross-sectional study in Korea

Dong Hyeon Lee1, Ji-Won Kwon2, Hyung Young Kim3

  • 1Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Clinical and Experimental Pediatrics
|February 7, 2020
PubMed

Insights

The asthma predictive index (API) correlates with current asthma in preschoolers, but not with lung function or allergy tests. This aids in diagnosing childhood asthma effectively.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Diagnostic Accuracy Studies

Background:

  • Diagnosing asthma in preschool children presents significant clinical challenges.
  • The asthma predictive index (API) is a tool used to predict asthma and guide treatment decisions in this age group.

Purpose of the Study:

  • To investigate the relationship between questionnaire-identified current asthma and the API.
  • To assess the association of current asthma with pulmonary function, airway hyperreactivity (AHR), fractional expiratory nitric oxide (FeNO), and atopic sensitization in preschool children.

Main Methods:

  • A population-based cross-sectional study involving 916 preschool children aged 4-6 years.
  • Current asthma was defined using a modified questionnaire, requiring physician diagnosis and at least one wheezing episode in the past 12 months.
  • Clinical and laboratory parameters were compared between children with and without current asthma.

Main Results:

  • The prevalence of current asthma was 3.9%.
  • Children with current asthma had higher rates of positive bronchodilator response and API scores (both loose and stringent).
  • The stringent API demonstrated 72.2% sensitivity and 82.0% specificity for current asthma (diagnostic accuracy 0.771), but no significant differences were found in spirometry, AHR, FeNO, or atopic sensitization.

Conclusions:

  • Questionnaire-based current asthma in preschoolers is associated with the asthma predictive index (API).
  • However, current asthma in this age group is not significantly associated with spirometry, airway hyperreactivity, FeNO levels, or atopic sensitization.
Abstract

Keywords:
AllergyAsthmaDiagnosisPreschool childWheezing

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