A childhood asthma severity scale: symptoms, medications, and health care visits

Background: Although there are current measures to evaluate childhood asthm a severity for clinical diagnosis and treatment, there is no standard valid measure to evaluate childhood asthma severity for large-scale epidemiologi c studies. Objectives: To develop and test a childhood asthma severity scale (CHAS) fo r clinimetric validity and to determine differences in symptoms, medication use, and health care visits by participant characteristics. Methods: Eight hundred ninety-seven actively asthmatic children under the a ge of 12 years were selected from a general population of children. Childre n were selected from a screening questionnaire administered at six Connecti cut hospitals that serve large minority populations in Bridgeport, New Have n, Hartford, and Danbury and one hospital serving south central Massachuset ts. Twelve-month baseline data for a prospective cohort study of childhood asthma severity were collected on a monthly basis through home interviews. Home interviews addressed questions on daily symptoms, medication use, and health care visits. A severity scale was constructed using three dimensions : symptoms, medication use, and health care visits. Results: CHAS has sufficient preliminary content, construct, and predictive validity. Despite similarities in symptoms, there were health care utiliza tion and medication differentials according to race and ethnicity, insuranc e status, family income, and maternal education. Conclusions: CHAS is a potentially useful measure of asthma severity for la rge-scale epidemiologic studies. It seems that CHAS has sufficient clinimet ric properties.