AAAAI 2023: Pediatric Asthma Risk Score Validated in Multi-cohort Study

Findings from a new multi-cohort study being presented at the 2023 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) confirmed the effectiveness of the Pediatric Asthma Risk Score (PARS).

“If we hope to initiate early prevention strategies, it is essential that we predict asthma as early as possible,” said primary author Jocelyn M. Biagini, PhD, of the Cincinnati Children’s Hospital Medical Center, in an AAAAI press release. “PARS is a continuous score that was developed to predict early-life asthma. We wanted to validate the results in cohorts that were more diverse than in original studies.”

Biagini and colleagues compared PARS directly to the Asthma Predictive Index (API) and validated it in 10 cohorts with varying race, ethnicity, sex, cohort type, missing data, and birth decades, and then performed a meta-analysis across all 10 cohorts, according to the abstract.

The research team used data from 5674 children participating in the Children’s Respiratory and Environmental Workgroup. They applied both PARS and API in each cohort, as well as harmonized data across all cohorts, and directly compared the ability of each tool to predict asthma development between ages 5-10 years.

Investigators observed that PARS area under the curve (AUC) was significantly higher than the AUC of the API in 9 cohorts (p-value range .01 to <.001), according to the study abstract. PARS AUC did not differ by cohort type (high risk or general population), decade of enrollment, race, sex, ethnicity, missing PARS factors or polysensitization definition (skin prick test vs specific IgE).

The weights of the 6 PARS factors in the meta-analysis were “very similar” to the original weights, “validating the original PARS scoring,” wrote Biagini et al.

“This multi-cohort study makes the PARS the most validated model of asthma prediction in children to date, not only with respect to the number of cohorts used but also with regards to capturing the diversity of asthma in the United States,” concluded researchers. “Future studies may consider PARS the new gold standard in pediatric asthma risk prediction.”

The study abstract is also available in a February supplement to the Journal of Allergy and Clinical Immunology: Biagini J, Martin L, He H, et al. The pediatric asthma risk score: A new gold standard for asthma prediction. J Allergy Clin Immunol. 2023;151. doi:10.1016/S0091-6749(22)02560-X