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Pediatric Asthma Impairment and Risk Questionnaire: A Control Assessment for Children Aged 5 to 11 Years
Kevin R Murphy1, Bradley Chipps2, Miguel J Lanz3
1Division of Allergy, Asthma and Immunology, Department of Pediatric Pulmonology, Boys Town National Research Hospital, Boys Town, Neb.
Insights
The Pediatric Asthma Impairment and Risk Questionnaire (Peds-AIRQ) effectively assesses childhood asthma control by evaluating symptoms and exacerbation risk. This validated tool aids in optimizing management for children aged 5-11 years.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Clinical Assessment Tools
Background:
- Uncontrolled childhood asthma leads to exacerbations and reduced quality of life.
- Current asthma control tools for children (5-11 years) focus on symptoms, potentially overestimating control and leading to suboptimal management.
- There is a need for tools that assess both symptom impairment and exacerbation risk in pediatric asthma.
Purpose of the Study:
- To validate the Pediatric Asthma Impairment and Risk Questionnaire (Peds-AIRQ).
- To assess the Peds-AIRQ's ability to evaluate asthma control in children aged 5-11 years by measuring symptom impairment and exacerbation risk.
- To establish reliable cut points for categorizing asthma control levels using the Peds-AIRQ.
Main Methods:
- A cross-sectional observational study involving 399 children (5-11 years) with diagnosed asthma.
- Parents/caregivers completed an 18-item questionnaire (Peds-AIRQ) on asthma symptoms and exacerbations, with child input.
- Logistic regression analyses were used to determine the best discriminating questions and cut points for asthma control categories (well-controlled, not well-controlled, very poorly controlled).
Main Results:
- The validated Peds-AIRQ consists of 5 impairment-based and 3 risk-based questions.
- The Peds-AIRQ demonstrated strong discriminatory ability with areas under the receiver-operating characteristic curves of 0.85 (WC vs. NWC/VPC) and 0.83 (WC/NWC vs. VPC).
- Cut points of 0-1, 2-4, and 5-8 "yes" responses correspond to well-controlled, not well-controlled, and very poorly controlled asthma, respectively.
Conclusions:
- The Peds-AIRQ is a validated, numerical assessment tool for evaluating asthma control in children aged 5-11 years.
- The tool effectively integrates current symptoms and exacerbation history for point-of-care assessment.
- The Peds-AIRQ supports more accurate asthma management by identifying children needing intensified therapy.
Background:
Uncontrolled asthma in childhood is associated with exacerbations and impaired health-related quality of life. Commonly used control tools for children aged 5 to 11 years assess asthma symptoms but not exacerbations, potentially leading to overestimation of control and suboptimal management.
Objective:
This cross-sectional observational study aimed to validate the Pediatric Asthma Impairment and Risk Questionnaire (Peds-AIRQ), a novel control tool assessing symptom impairment and exacerbation risk.
Methods:
A total of 399 children aged 5 to 11 years with physician-diagnosed asthma were recruited from one primary care and seven specialty care sites across the United States. Parents and caregivers, with input from their child, answered 18 yes/no questions about asthma symptoms and exacerbations. Children were categorized as having well-controlled (WC), not well-controlled (NWC), or very poorly controlled (VPC) asthma according to a validation standard using Global Initiative for Asthma symptom control questions plus prior-year exacerbations. Items with the greatest ability to discriminate among control categories and cut points were determined through logistic regression analyses.
Results:
Models yielded a Peds-AIRQ composed of five impairment-based and three risk-based questions. The Peds-AIRQ yielded areas under receiver-operating characteristic curves of 0.85 to differentiate WC versus NWC/VPC asthma and 0.83 to differentiate WC/NWC versus VPC asthma. Score cut points of 0 to 1, 2 to 4, and 5 to 8 yes responses were determined to best represent WC, NWC, and VPC asthma, respectively.
Conclusions:
The Peds-AIRQ is a validated numerical assessment tool for children aged 5 to 11 years that can be used at point-of-care to evaluate asthma control based on current symptoms and exacerbation history.
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