Validation of the Pulmonary Score: An Asthma Severity Score for Children

Smith, Sharon R.; Baty, Jack; Hodge, Dee

doi:10.1111/j.1553-2712.2002.tb00223.x

Cited by 59 publications

(43 citation statements)

References 7 publications

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“…The few clinical scores cited that have been subject to more rigorous study, including measures of reliability, validity, and responsiveness, include the Preschool Respiratory Assessment Measure (PRAM), 6 the Clinical Asthma Score (CAS), 11 the Asthma Severity Scale (ASS), 12 the Pulmonary Index (PI), 5 and the Pulmonary Score (PS). 13 Characteristics of these scores and their validation are summarized in Table 7.…”

Section: Discussionmentioning

confidence: 99%

“…The correlation coefficients in our study were somewhat lower than those reported for the PS, which ranged from 0.44 to 0.67. 13 However, although PEFR is a good indicator of the degree of airway obstruction, it is not a criterion standard. 16 Interpreting the relationship between imperfect measures is problematic, but the magnitude of the correlation between the PASS and PEFR is similar to that reported for several other scores in the literature, as noted above.…”

Section: Limitationsmentioning

confidence: 99%

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Performance of a Novel Clinical Score, the Pediatric Asthma Severity Score (PASS), in the Evaluation of Acute Asthma

Gorelick

Stevens

Schultz

et al. 2004

Academic Emergency Medicine

137

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Objectives: To evaluate the reliability, validity, and responsiveness of a new clinical asthma score, the Pediatric Asthma Severity Score (PASS), in children aged 1 through 18 years in an acute clinical setting. Methods: This was a prospective cohort study of children treated for acute asthma at two urban pediatric emergency departments (EDs). A total of 852 patients were enrolled at one site and 369 at the second site. Clinical findings were assessed at the start of the ED visit, after one hour of treatment, and at the time of disposition. Peak expiratory flow rate (PEFR) (for patients aged 6 years and older) and pulse oximetry were also measured. Results: Composite scores including three, four, or five clinical findings were evaluated, and the threeitem score (wheezing, prolonged expiration, and work of breathing) was selected as the PASS. Interobserver reliability for the PASS was good to excellent (kappa ¼ 0.72 to 0.83).There was a significant correlation between PASS and PEFR (r ¼ 0.27 to 0.37) and pulse oximetry (r ¼ 0.29 to 0.41) at various time points. The PASS was able to discriminate between those patients who did and did not require hospitalization, with area under the receiver operating characteristic curve of 0.82. Finally, the PASS was shown to be responsive, with a 48% relative increase in score from start to end of treatment and an overall effect size of 0.62, indicating a moderate to large effect. Conclusions: This clinical score, the PASS, based on three clinical findings, is a reliable and valid measure of asthma severity in children and shows both discriminative and responsive properties. The PASS may be a useful tool to assess acute asthma severity for clinical and research purposes.

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Performance of a Novel Clinical Score, the Pediatric Asthma Severity Score (PASS), in the Evaluation of Acute Asthma

Gorelick

Stevens

Schultz

et al. 2004

Academic Emergency Medicine

137

View full text Add to dashboard Cite

show abstract

“…The PS is used routinely and has 3 domains (respiratory rate, wheeze, and degree of retractions) with 3 possible points per domain (score range 0 to 9). 28 …”

Section: Methodsmentioning

confidence: 99%

Exhaled Nitric Oxide Levels During Treatment of Pediatric Acute Asthma Exacerbations and Association With the Need for Hospitalization

Nelson¹,

Lee²,

Trinkaus³

et al. 2011

Pediatric Emergency Care

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“…Although more than 16 severity scoring systems exist, many are difficult to use. 3 For example, some severity measures require blood gas analyses; others require numerous objective measures, or demanding assessments such as inspiratory/expiratory ratios. [4][5][6][7] The pulmonary score (PS) was developed to provide a ''userfriendly'' measure of asthma severity for children with an acute asthma exacerbation.…”

Section: Introductionmentioning

confidence: 99%

Validation of Pulmonary Score in the Evaluation of Acute Exacerbation of Asthma

Chandrakala¹,

Ramesh²,

Rao³

2014

jemds

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BACKGROUND & OBJECTIVES:Numerous asthma scoring systems have been devised which combine a number of physical signs to estimate the severity of an acute asthma exacerbation. Although more than 16 scoring systems exist, many are difficult to use. The pulmonary score was developed to provide ''user-friendly'' measure of asthma severity for children with acute asthma exacerbation. The objective of the study is to study the efficacy of pulmonary score in assessing the severity of acute exacerbation of asthma in comparison to peak expiratory flow rate. METHODS: The study sampled 50 children, aged 5-18 years, with mild to moderate acute exacerbation of asthma. The PEFR (best of three attempts) and the PS were measured before and after treatment at 5, 10 and 15 minutes. The PS includes respiratory rate, wheezing, and retractions, each rated on a 0-3 scale. Pre-and post-treatment PEFR and PS score were compared using paired t-tests to establish construct validity. Correlation of pre-and post-treatment PSs with PEFRs was measured to establish criterion validity. RESULTS: The mean predicted PEFR improved with treatment by 21.2% (from 50.8% to 72.0% of predicted) (p <0.0001) at 15 minutes. The mean PS improved by 2.8 (from 4.8 to 2) (p < 0.0001) at 15 minutes. Pre-and post-treatment PSs were significantly correlated with PEFRs. The correlation of pre-treatment PEFR and PS is r = -0.497 (p = 0.000), that for post treatment at 15 minutes is r = -0.589 (p = 0.000). INTERPRETATION & CONCLUSION: These data support the construct and criterion validities of the PS as a measure of asthma severity among children. The PS is a practical substitute to estimate airway obstruction in children who are too young or too sick to obtain PEFRs.

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Validation of the Pulmonary Score: An Asthma Severity Score for Children

Abstract: These data support the construct and criterion validities of the PS as a measure of asthma severity among children in the ED. The PS is a practical substitute to estimate airway obstruction in children who are too young or too sick to obtain PEFRs.

Cited by 59 publications

References 7 publications

Performance of a Novel Clinical Score, the Pediatric Asthma Severity Score (PASS), in the Evaluation of Acute Asthma

Performance of a Novel Clinical Score, the Pediatric Asthma Severity Score (PASS), in the Evaluation of Acute Asthma

Exhaled Nitric Oxide Levels During Treatment of Pediatric Acute Asthma Exacerbations and Association With the Need for Hospitalization

Validation of Pulmonary Score in the Evaluation of Acute Exacerbation of Asthma

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