Publication: Development of the Siriraj Clinical Asthma Score
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Issued Date
2013-11-29
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ISSN
22288694
0125877X
0125877X
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2-s2.0-84887576113
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Mahidol University
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SCOPUS
Bibliographic Citation
Asian Pacific Journal of Allergy and Immunology. Vol.31, No.3 (2013), 210-216
Suggested Citation
Pakit Vichyanond, Jittima Veskitkul, Nuanphong Rienmanee, Punchama Pacharn, Orathai Jirapongsananuruk, Nualanong Visitsunthorn Development of the Siriraj Clinical Asthma Score. Asian Pacific Journal of Allergy and Immunology. Vol.31, No.3 (2013), 210-216. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/31835
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Title
Development of the Siriraj Clinical Asthma Score
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Abstract
Introduction: Acute asthmatic attack in children commonly occurs despite the introduction of effective controllers such as inhaled corticosteroids and leukotriene modifiers. Treatment of acute asthmatic attack requires proper evaluation of attack severity and appropriate selection of medical therapy. In children, measurement of lung function is difficult during acute attack and thus clinical asthma scoring may aid physician in making further decision regarding treatment and admission. Methods: We enrolled 70 children with acute asthmatic attack with age range from 1 to 12 years (mean ± SD = 51.5 ± 31.8 months) into the study. Twelve selected asthma severity items were assessed by 2 independent observers prior to administration of salbutamol nebulization (up to 3 doses at 20 minutes interval). Decision for further therapy and admission was made by emergency department physician. Three different scoring systems were constructed from items with best validity. Sensitivity, specificity and accuracy of these scores were assessed. Inter-rater reliability was assessed for each score. Review of previous scoring systems was also conducted and reported. Results: Three severity items had poor validity, i.e., cyanosis, depressed cerebral function, and I:E ratio (p > 0.05). Three items had poor inter-rater reliability, i.e., breath sound quality, air entry, and I:E ratio. These items were omitted and three new clinical scores were constructed from the remaining items. Clinical scoring system comprised retractions, dyspnea, O2 saturation, respiratory rate and wheezing (range of score 0-10) gave the best accuracy and inter-rater variability and were chosen for clinical use - Siriraj Clinical Asthma Score (SCAS). Conclusion: A Clinical Asthma Score that is simple, relatively easy to administer and with good validity and variability is essential for treatment of acute asthma in children. Several good candidate scores have been introduced in the past. We described the development of the Siriraj Clinical Asthma Score (SCAS) in this report and reviewed the literature on the development of clinical asthma score for use in children.