Performance of the Pediatric Asthma Risk Score across Diverse Populations
Recommended Citation
Biagini JM, Martin LJ, He H, Bacharier LB, Gebretsadik T, Hartert TV, Jackson DJ, Kim H, Miller RL, Rivera-Spoljaric K, Schauberger EM, Singh AM, Visness CM, Wegienka G, Ownby DR, Gold DR, Martinez FD, Johnson CC, Wright AL, Gern JE, and Khurana Hershey GK. Performance of the Pediatric Asthma Risk Score across Diverse Populations. NEJM Evid 2023; 2(10):EVIDoa2300026.
Document Type
Article
Publication Date
10-1-2023
Publication Title
NEJM Evid
Abstract
BACKGROUND: Methods to determine whether a toddler is likely to develop asthma are of value to parents and clinical trialists testing primary prevention strategies. The Pediatric Asthma Risk Score (PARS) is a 14-point score of six factors designed to predict asthma in early life. PARS was developed and validated in relatively homogenous populations, so its generalizability is unknown.
METHODS: We computed PARS using the six factors of self-declared race (parent-reported as “Black” or “not Black”), parental asthma, eczema, any wheezing, wheezing without a cold, and polysensitization in 5634 children from birth to 3 years of age. The primary outcome of our analysis was the ability of PARS to predict asthma development at 5 to 10 years of age using the area under the receiver operating curve in each cohort and across all cohorts with varying ethnicity, sex, cohort type, birth decades, missing PARS factors, and polysensitization definition. We also performed a meta-analysis across all the cohorts. Finally, we compared PARS predictive ability with the binary Asthma Predictive Index (API).
RESULTS: Across 10 cohorts, the area under the receiver operating curve for PARS was 0.76. PARS performance did not differ by ethnicity, sex, cohort type, enrollment decade, missing PARS factors, or polysensitization definition (all P>0.05). The weights of each factor in the meta-analysis were similar to the original PARS weights. PARS and API equally identified children at high risk for developing asthma or not; API missed 31% of children at moderate asthma risk.
CONCLUSIONS: PARS provided robust estimates of asthma risk in children from a wide range of ethnicities, backgrounds, and susceptibility. (Funded by the National Institute of Allergy and Infectious Diseases and others.)
Medical Subject Headings
Humans; Asthma; Risk Factors
PubMed ID
38320177
Volume
2
Issue
10
First Page
2300026
Last Page
2300026
