Assessment of a simple scoring system applied to a screening questionnaire of asthma in children aged 5-15 yrs

Abstract

The aim of the present study was to validate a simple scoring system using a parent-completed screening questionnaire to identify children aged 5±15 yrs who may have asthma.A stratified random sample of 157 children of 1,808 whose parents had answered a postal respiratory questionnaire underwent detailed clinical evaluation. The results were reviewed by three independent paediatricians whose opinions were combined to reach, for each child, decisions regarding three standards: 1) "possible asthma" defined as >50% likelihood of having asthma; 2) "possible asthma" defined as meriting a clinical trial of asthma medication; and 3) "probable asthma" defined as >90% likelihood of having asthma. The combined decisions were compared to three sets of questionnaire scores, in order to determine the positive predictive value, sensitivity and specificity of each set in identifying children with probable/possible asthma.The three sets of chosen questionnaire scores all had positive predictive values of 79±96% for predicting possible asthma, using either the combined expert opinion ">50% likelihood of asthma" or that of "warrants a trial of treatment" as the definition. This suggests that a low proportion of false positives would be obtained were this scoring system to be used for a screening programme. The combined decision >90% chance of asthma could be used as a means of estimating prevalence of asthma in the survey. When used for this, the prevalence of asthma in the surveyed population was 18.8% (95% confidence interval 13.1±26.3).In conclusion, the present scoring system, based on a simple respiratory questionnaire, provides a valid method of identifying children likely to have asthma, and who, if unknown to the medical services, would benefit from clinical review.

Prevalence of Asthma in School going Children of Semi-Urban Area in the State of Madhya Pradesh

“…1 Increase in the rates of hospital admission and primary care contacts for asthma in childhood has led to concern regarding prevalence or severity of increasing wheezing illness in children. Rise in prevalence of childhood asthma is a matter of concern worldwide and in India also.…”

Respiratory illness and healthcare utilization in children: the primary and secondary care interface

“…Children who were likely asthmatics, if not known to the practice, would require clinical assessment to determine their asthma status. An evaluation of this scoring system [11] has shown that increasing numbers of positive responses to these key questions increase the likelihood of a child benefiting from a trial of asthma medication. Three or more positive responses had a positive predictive value (PPV) of 84% (95% confidence interval (CI) 74 -90) to identify such children who were, therefore, classed as "likely asthmatics".…”

Prevalence of respiratory symptoms, features of asthma, and characteristics associated with respiratory disease, in 6–11 year olds in Manchester

“…The WYCAP questionnaire has been validated for use in children aged between 5 and 15 years. 8 Skin prick tests were carried out to identify the prevalence of atopic sensitisation.…”

“…The questionnaire (see Appendix A, available online at www.thepcrj.org), a modified version of the ISAAC core questionnaire for wheezing and asthma, 6 was based on that used in the Wythenshawe Community Asthma Project (WYCAP). 8 Reminders were sent to non-responders after four and eight weeks and at the end of the distribution period. The return of a completed questionnaire was considered as consent to participate in the study.…”