Asthma is one of the most common chronic conditions in children and adults with a prevalence of over 8% in U.S. children and 7% in adults. This translates to over 7 million children in the U.S. have asthma and over 26 million total. In 2007, the National Heart Lung and Blood Institute (NHLBI) released their Expert Panel Report 3 for the management of asthma. These guidelines are still in effect with minor updates over the years. More recent guidelines are available from the Global Initiative for Asthma (GINA). Both guidelines have similar recommendations including the use of asthma action plans for example through the GINA are more up-to-date with the current best evidence.

One common question that comes up in practice is, “Will my child develop asthma?” or “Is this wheezing asthma?”  I had this question in my clinic last week (see scenario below). This is not an easy question to answer. Many of us know common risk factors for asthma, including parental history of asthma, African American race, eczema, early wheezing, but what risk does that individual patient have for developing asthma? The Cincinnati Children’s Hospital Medical Center sponsors this app based on research from their staff and the U.K. to create the Pediatric Asthma Risk Score (PARS) app. The authors attempted to create a simple risk score using historical data with requiring lab tests. By answering six questions about eczema, wheezing, race, sensitization status, and parental asthma history, app users are able to determine a child’s risk of developing asthma. The PARS reliably predicted asthma with an improved sensitivity (0.64) and PPV (0.38) with similar specificity (0.8) and NPV (0.92) when compared to the Asthma Predictive Index (API).

Let’s take a look at the PARS app via a patient scenario: You are seeing Andy, a 3-year-old male with a history of eczema and wheezing before age 3. John’s mother, who has asthma, asks you if he will have asthma when he is older. What do you tell her? What is your answer if Andy was African American?

Evidence-based medicine

The app lists its authors and their research from Cincinnati Children’s Hospital Medical Center on the opening screen, but no links to the evidence. The score is available in multiple formats including downloadable PDF and Word formats.

What providers would benefit from this medical app?

Parents, researchers, students, residents, mid-levels, emergency medicine, primary care providers. Any provider who sees children with asthma/possible asthma.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.