Study objectives: The purpose of this study was to
confirm the validity of a brief screen for pediatric asthma in
Background: Asthma is the most common
chronic disease of childhood, yet the frequency with which this
condition is recognized among school-aged children varies widely.
Several methods are used to increase the accuracy of detection of
asthma, but many are cumbersome and difficult to apply on a large
Design: We elected to validate a five-question
instrument, the Brief Pediatric Asthma Screen (BPAS), to screen for the
presence of asthma among children attending school in Region 5 of the
Chicago school district, where the schools report a 2.7% frequency of
asthma. The questionnaire was distributed to the parents of
grade-school children at the time of report-card pick-up.
Setting: A clinical assessment was performed on a selected
group of children whose parents completed the questionnaire in a school
and in a hospital outpatient clinic.
Of 4,147 questionnaires that we distributed, 1,796 (43%) were returned.
We excluded 341 children (19% of the total sample) whose parents
reported that they had been diagnosed with asthma. The remaining pool
indicated that the children of 183 responders (10%) had symptoms
suggestive of asthma, while 1,272 parents (71%) indicated that their
children did not have symptoms of asthma.
results: We selected 90 of the respondents who did not indicate
that their children had a diagnosis of asthma. Of this group, 81
completed the validation, in which their responses suggested symptoms
of asthma (n = 34) or no asthma symptoms (n = 47). The children of
these respondents were given a blinded clinical evaluation consisting
of history, physical examination, and spirometry. The survey
demonstrated a sensitivity of 75% and a specificity of 81.2% for the
presence of asthma among those who were unaware of the diagnosis.
Conclusions: The BPAS is brief, can be filled out by
parents, and appears accurate in detecting