Hatoun et al reported the Asthma Exacerbation Risk (AER) Score for evaluating pediatric patients using claims data. This can help to identify a pediatric patient at greater risk for an exacerbation of asthma. The authors are from Boston Children's Hospital.
Patient selection: age 2 to 18 years with asthma
Parameters over the past year:
(1) number of nonexacerbation PCP or asthma specialist visits
(2) number of asthma medications
(3) number of ICS-LABA combination fills (inhaled corticosteroid, long-acting beta-agonist)
(4) number of oral steroid fills
(5) time since last exacerbation in months
(6) age in years
(7) HEDIS persistent asthma on 2-year lookback
(8) spirometry procedure performed
|
Parameter
|
Finding
|
Points
|
|
nonexacerbation visits
|
0
|
0
|
|
|
1
|
3
|
|
|
>= 2
|
4
|
|
number of asthma meds
|
0
|
0
|
|
|
>= 1
|
3
|
|
number of ICS-LABA combination fills
|
0
|
0
|
|
|
>= 1
|
3
|
|
number of oral steroid fills
|
0
|
0
|
|
|
>= 1
|
2
|
|
time since last exacerbation
|
0 to 6 months
|
2
|
|
|
> 6 months
|
0
|
|
age in years
|
2 to 6 years
|
2
|
|
|
7 to 11 years
|
1
|
|
|
12 to 18 years
|
0
|
|
HEDIS persistent asthma
|
no
|
0
|
|
|
yes
|
1
|
|
spirometry performed
|
no
|
0
|
|
|
yes
|
-1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -1
• maximum score: 17
|
Total Score
|
Rate of Asthma Exacerbation
|
|
0
|
0.3%
|
|
1
|
0.4%
|
|
2
|
0.6%
|
|
3
|
2%
|
|
4
|
2.8%
|
|
5
|
5.8%
|
|
6
|
6.3%
|
|
7
|
8.9%
|
|
8
|
11.3%
|
|
9
|
10.4%
|
|
>= 10
|
26%
|
Performance:
• The area under the ROC curve was 0.85 in the derivation and 0.81 in the validation cohorts.
