Clin Exp Pediatr.  2020 Mar;63(3):104-109. 10.3345/kjp.2019.00640.

Asthma predictive index as a useful diagnostic tool in preschool children: a cross-sectional study in Korea

  • 1Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Department of Pediatrics, Seoul National University Bundang Hospital, Sungnam, Korea
  • 3Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
  • 4Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
  • 5Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
  • 6Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 7Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
  • 8Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
  • 9Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea


It is challenging to diagnose asthma in preschool children. The asthma predictive index (API) has been used to predict asthma and decide whether to initiate treatment in preschool children. Purpose: This study aimed to investigate the association between questionnaire-based current asthma with API, pulmonary function, airway hyperreactivity (AHR), fractional expiratory nitric oxide (FeNO), and atopic sensitization in preschool children.
We performed a population-based cross-sectional study in 916 preschool children aged 4–6 years. We defined current asthma as the presence of both physician-diagnosed asthma and at least one wheezing episode within the previous 12 months using a modified International Study of Asthma and Allergies in Childhood questionnaire. Clinical and laboratory parameters were compared between groups according to the presence of current asthma.
The prevalence of current asthma was 3.9% in the study population. Children with current asthma showed a higher rate of positive bronchodilator response and loose and stringent API scores than children without current asthma. The stringent API was associated with current asthma with 72.2% sensitivity and 82.0% specificity. The diagnostic accuracy of the stringent API for current asthma was 0.771. However, no intergroup differences in spirometry results, methacholine provocation test results, FeNO level, or atopic sensitization rate were observed.
The questionnaire-based diagnosis of current asthma is associated with API, but not with spirometry, AHR, FeNO, or atopic sensitization in preschool children.


Asthma; Preschool child; Wheezing; Allergy; Diagnosis
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