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Comparative Study
. 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

Donald H Arnold  1 , Tebeb Gebretsadik, Thomas J Abramo, Karel G Moons, James R Sheller, Tina V Hartert
Affiliations
Comparative Study

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

Donald H Arnold et al. Ann Allergy Asthma Immunol. 2011 Jul.

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.

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Figures

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Participant enrollment and study progress.
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