PARS vs Asthma Predictive Index for Predicting Allergic, Nonallergic Asthma

The Pediatric Asthma Risk Score (PARS) may be able to predict the development of allergic and nonallergic asthma in children, according to study results published in the Annals of Allergy, Asthma and Immunology.

PARS values were obtained for infants born to atopic parents in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) and the UK population-based, Isle of Wight 1989-1990 birth cohort served as the replication population. Children had examinations at 1, 2, 3, 4 and 7 years of age with allergy symptoms, wheezing frequency, wheezing apart from colds, and skin symptoms recorded. Risk factors for PARS included parental asthma, eczema at ages 1 to 3, early wheezing at ages 1 to 3, wheezing apart from colds, polysensitization, and African ancestry. Allergic asthma and nonallergic asthma were defined as asthma with or without a positive skin-prick test (SPT) at any time point.

Of the 589 patients in the CCAAPS cohort who completed the assessments at age 7, 95 had asthma based on reported symptoms and measures of lung function. Of these 95 patients, 71 were classified as allergic asthma and 24 were classified as nonallergic asthma.

The area under the curve (AUC) analysis demonstrated that the PARS predicted allergic asthma significantly better than the Asthma Predictive Index (API) in the CCAAPS cohort (AUC=0.82; 95% CI, 0.77-0.87 vs AUC=0.71; 95% CI, 0.65-0.77) and in the Isle of Wight cohort (AUC, 0.87; 95% CI, 0.84-0.91 vs AUC=0.74; 95% CI, 0.69-0.79). PARS also better predicted nonallergic asthma than the API, but this was only significant in the UK cohort.

“The PARS had a significant performance improvement in the ability to accurately forecast the development of allergic and nonallergic asthma over the API,” the researchers wrote. “Future studies need to be directed at 1) replicating and building upon these findings in larger and diverse cohorts with [ethnicities] not represented here [and] 2) application of the PARS to identify at-risk children for asthma intervention trials.”

Reference

Schauberger E, Biagini Myers JM, He H, et al. The Pediatric Asthma Risk Score (PARS) predicts allergic and non-allergic asthma [published online March 19, 2020]. Ann Allergy Asthma Immunol. doi:10.1016/j.anai.2020.03.010