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Ann Allergy Asthma Immunol. 2011 Jul;107(1):22-8. doi: 10.1016/j.anai.2011.03.011. Epub 2011 Apr 22.

The RAD score: a simple acute asthma severity score compares favorably to more complex scores.

Author information

1
Department of Pediatrics, Division of Emergency Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA. don.arnold@vanderbilt.edu

Erratum in

  • Ann Allergy Asthma Immunol. 2014 Mar;112(3):273.

Abstract

BACKGROUND:

Acute asthma severity scores facilitate assessment and implementation of timely and appropriate therapy for pediatric patients but are complex and challenging for clinicians to use at the bedside.

OBJECTIVE:

To assess whether a simple, bedside acute asthma severity score comprising 3 standard clinical measures performs as well as more comprehensive asthma scores.

METHODS:

We prospectively enrolled participants 5 to 17 years of age with acute asthma exacerbations. We recorded 3 asthma scores at baseline and after 2 hours of treatment: the Pediatric Asthma Severity Score (PASS), the Pediatric Respiratory Assessment Measure (PRAM), and the RAD score (Respiratory rate; Accessory muscle use; Decreased breath sounds). We assessed each score for criterion validity in predicting baseline percent forced expiratory volume in 1 second (%FEV(1)) and for responsiveness in predicting change of %FEV(1) after 2 hours of treatment using multiple linear regression models adjusted for age, race, sex, and Global Initiative for Asthma chronic control.

RESULTS:

Of 536 participants included for analyses, median age was 8.8 years, 60% were male, and 58% were African American. The 3 acute asthma scores demonstrated similar criterion validity to explain variation of baseline %FEV(1) (R(2): 0.434 [PASS]; 0.462 [PRAM]; 0.426 [RAD]), but none demonstrated clinically significant responsiveness to change in %FEV(1) (R(2): 0.109 [PASS]; 0.106 [PRAM]; 0.139 [RAD]).

CONCLUSIONS:

The RAD score, comprising 3 routinely measured bedside clinical parameters, is a simple and easily used instrument for assessing the severity of an acute asthma exacerbation and has comparable criterion validity and improved responsiveness when compared with 2 more complex acute asthma scores.

PMID:
21704881
PMCID:
PMC3760486
DOI:
10.1016/j.anai.2011.03.011
[Indexed for MEDLINE]
Free PMC Article

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