Pediatric Asthma Impairment and Risk Questionnaire: A Control Assessment for Children Aged 5 to 11 Years

BACKGROUND: Uncontrolled asthma in childhood is associated with exacerbations and impaired health-related quality of life. Commonly used control tools for children aged 5 to 11 years assess asthma symptoms but not exacerbations, potentially leading to overestimation of control and suboptimal management. OBJECTIVE: This cross-sectional observational study aimed to validate the Pediatric Asthma Impairment and Risk Questionnaire (Peds-AIRQ), a novel control tool assessing symptom impairment and exacerbation risk. METHODS: A total of 399 children aged 5 to 11 years with physician-diagnosed asthma were recruited from one primary care and seven specialty care sites across the United States. Parents and caregivers, with input from their child, answered 18 yes/no questions about asthma symptoms and exacerbations. Children were categorized as having well-controlled (WC), not well-controlled (NWC), or very poorly controlled (VPC) asthma according to a validation standard using Global Initiative for Asthma symptom control questions plus prior-year exacerbations. Items with the greatest ability to discriminate among control categories and cut points were determined through logistic regression analyses. RESULTS: Models yielded a Peds-AIRQ composed of five impairment-based and three risk-based questions. The Peds-AIRQ yielded areas under receiver-operating characteristic curves of 0.85 to differentiate WC versus NWC/VPC asthma and 0.83 to differentiate WC/NWC versus VPC asthma. Score cut points of 0 to 1, 2 to 4, and 5 to 8 yes responses were determined to best represent WC, NWC, and VPC asthma, respectively. CONCLUSIONS: The Peds-AIRQ is a validated numerical assessment tool for children aged 5 to 11 years that can be used at point-of-care to evaluate asthma control based on current symptoms and exacerbation history.