Validation of the brief pediatric asthma screen

Study objectives: The purpose of this study was to confirm the validity of a brief screen for pediatric asthma in schools. Background: Asthma is the most common chronic disease of childhood, yet the frequency with which this condition is recognized among school-aged childr en varies widely. Several methods are used to increase the accuracy of dete ction of asthma, but many are cumbersome and difficult to apply on a large scale. Design: We elected to validate a five-question instrument, the Brief Pediat ric Asthma Screen (BPAS), to screen for the presence of asthma among childr en attending school in Region 5 of the Chicago school district, where the s chools 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 childre n whose parents completed the questionnaire in a school and in a hospital o utpatient clinic. Participants: 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 indi cated that the children of 183 responders (10%) had symptoms suggestive of asthma, while 1,272 parents (71%) indicated that their children did not hav e symptoms of asthma, Measurements and results: We selected 90 of the respondents who did not ind icate that their children had a diagnosis of asthma, Of this group, 81 comp leted 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 ex amination, and spirometric. The sun ev demonstrated a sensitivity of 75% an d a specificity of 81.2% for the presence of asthma among those who were un aware of the diagnosis. Conclusions: The BPAS is brief, can be filled out by parents, and appears a ccurate in detecting asthma.