• Esther Maria Sampayo, Amber Chew, and Joseph J Zorc.
• Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399, USA. sampayo@email.chop.edu
• Pediatr Emerg Care. 2010 Jan 1; 26 (1): 1-5.

ObjectiveTo develop and validate a brief assessment instrument for persistent asthma symptoms in a pediatric emergency department (ED) population.MethodsParents of children aged 1 to 18 years being discharged home after treatment for acute asthma in an urban children's hospital completed a 6-item screen for persistent symptoms that had been developed from national guidelines and previously validated. During a follow-up phone call 4 weeks after the ED visit, the instrument was repeated. An 8-item asthma-related quality-of-life (ARQOL) instrument was also administered at both times to assess construct validity. Item analysis assessed the performance of individual items and their combination versus the full instrument.ResultsFour hundred thirty-three children were enrolled, and 361 patients (83%) had complete data. Sensitivity and predictive value were calculated for the full screen and combination of items in detecting persistent symptoms at baseline and follow-up. A 3-item version included symptoms with activity, symptoms at night, and need for rescue albuterol. This version was 96% sensitive (95% confidence interval, 92-99) for persistent symptoms compared with the 6-item screen, and 69% (95% confidence interval, 62-76) of the participants continued to report persistent symptoms 4 weeks after the visit. For both screens, subjects with persistent symptoms had significantly worse ARQOL score at baseline and follow-up.ConclusionsA brief screen can identify persistent symptoms in pediatric ED patients with good sensitivity compared with a longer instrument. Most of these patients will continue to report persistent symptoms and reduced ARQOL score 1 month after the ED visit and may be candidates for additional interventions in the ED to improve long-term asthma care.

24 keywords...

hide…