Infantile and preschool asthma

Predicting persistence of asthma in preschool wheezers: crystal balls or muddy waters?

“…The stringent API, 25 the Isle of Wight score 27 and the PIAMA risk score 29 presented relatively high positive LRs in their derivation cohorts (Table 3); the stringent API has been praised in particular for this characteristic in a recent review. 34 However, two notes of caution are required. First, these moderately high 44,45 positive LRs were achieved at the cost of unacceptably high negative LRs and false negative rates (Table 3).…”

“…13,16,17 Therefore, efforts to identify factors related to the persistence of asthma among preschool wheezers have mainly focused on simple clinical and laboratory parameters, [18][19][20][21][22][23][24] which have been combined into predictive models aiming to identify children at risk [25][26][27][28][29] (Table 1). The Asthma Predictive Index 25 (API) has become by far the most popular among these predictive tools; it has been introduced in international guidelines 30,31 and position papers, 17,[32][33][34] and it has been used to select high-risk children for clinical trials, [35][36][37] or as the ''gold standard'' to compare other predictive rules in population-based studies. 29,38 However, its usefulness in clinical practice has recently been questioned.…”

Parasternal intercostal electromyography: a novel tool to assess respiratory load in children

“…pulmonary function tests has been highlighted as a barrier to optimal treatment in wheezy preschool children (26). While techniques such as respiratory interrupter resistance and forced oscillation technique have entered clinical use in some centers, the practicalities of obtaining technically acceptable data in young patient populations limit the wider uptake of such measures.…”

Treatment of asthma in young children: evidence-based recommendations

“…The Asthma Predictive Index (API) [8], originally developed in the Tucson cohort study, is the most widely used. The API is simple and cheap, and its major strength is its good positive likelihood ratio ~7.4 (the post-test probability of disease can improved from 2 to 7 times) and high specificity (~97 %) [9]. …”