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Paediatrics · Pulmonology

PIAMA Asthma Risk Score calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Sex
Postterm delivery

Table I defines postterm delivery as more than 42 weeks. That finding is 7.3 points.

Medium or low parental education

Medium or low education of at least one parent is 4.2 points.

Parental inhalation medication
Wheezing frequency

Table III prints 4.2 points for 1 to 3 times per year and 9.1 points for 4 times per year. The univariate table prints more than 3 times per year for the higher row, so 4 or more uses 9.1 points.

years

Allowed range: 0–4 years

Age over 70 years scores 1. Age 70 scores 0.

Wheezing or dyspnea apart from colds

This item is 7.1 points only at age 3 or 4 years. Below 3 years it is 0 points even if present.

Serious respiratory infections

Table III prints 4.6 points for 1 to 2 times per year and 6.9 points for 3 times per year. No higher row is printed, so 3 or more uses 6.9 points.

Doctor's diagnosis of eczema and rash present

Both a doctor's diagnosis of eczema and an eczematous rash present are required for 8.2 points.

Result

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Clinical inputs

  • Sex
  • Postterm delivery
  • Medium or low parental education
  • Parental inhalation medication
  • Wheezing frequency
  • Age (years)Accepted range: 0 to 4
  • Wheezing or dyspnea apart from colds
  • Serious respiratory infections
  • Doctor's diagnosis of eczema and rash present

Primary source

Caudri D et al. Predicting the long-term prognosis of children with symptoms suggestive of asthma at preschool age. J Allergy Clin Immunol. PMID: 19665765. Table III points after validation: male sex 4.6, postterm delivery 7.3, medium or low parental education 4.2, parental inhalation medication 7.7, wheezing 1 to 3 times per year 4.2, wheezing 4 times per year 9.1, wheezing or dyspnea apart from colds 7.1, serious infections 1 to 2 times per year 4.6, serious infections 3 times per year 6.9, doctor's diagnosis of eczema and eczematous rash present 8.2. The printed total is 55.1. None is 0 points. Table I defines postterm as more than 42 weeks and the higher wheezing row as more than 3 times per year, so a count of 4 or more uses 9.1 points. No infection row above 3 times per year is printed, so a count of 3 or more uses 6.9 points. The footnote on wheezing or dyspnea apart from colds says that item is only available at age 3 or 4 years and is negative by default in younger children. Table IV cutoffs, with a score at or above the cutoff counted as positive: 10 (sensitivity 93, specificity 28, positive predictive value 14, negative predictive value 97), 15 (82, 51, 17, 96), 20 (60, 76, 23, 94), 25 (36, 91, 32, 92), 30 (19, 97, 42, 91), 35 (7, 99, 50, 90). The text says fewer than 10 points corresponded to 3% asthma at 7 to 8 years, a cutoff of 20 accounted for 60% of cases, 30 or higher corresponded to 42%, and 35 or higher corresponded to 50% (17 of 34). The score range in the text is 0 to 55. (2009)

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