Catro-Rodriguez et al used simple clinical findings to identify a young child who is more likely to develop asthma during later childhood. The authors are from the University of Arizona in Tucson.
Patient selection: wheezing during the first 3 years of life (early wheezer)
Frequent wheezer: score >= 3 on a 6 point Likert scale anchored as very rarely to most days
Major criteria:
(1) diagnosis of asthma in a parent made by a physician
(2) diagnosis of eczema by a physician
Minor criteria:
(1) diagnosis of allergic rhinitis by a physician
(2) wheezing apart from colds
(3) eosinophilia (percent eosinophils in differential count >= 4%) at 1 year of age
Loose index - one or both of the following associated with any wheezing:
(1) >= 1 major criteria
(2) >= 2 minor criteria
Stringent index - one or both of the following associated with frequent wheezing:
(1) >= 1 major criteria
(2) >= 2 minor criteria (with second minor criteria associated with inclusion criterion)
Interpretation:
• A positive loose index was associated with 2.6 to 5.5 fold increase in active asthma between ages 6 and 13 years of age.
• A positive stringent index was associated with a 4.3 to 9.8 fold increase in active asthma between ages 6 and 13 years of age
• A negative stringent index had a negative predictive value of > 95%.
