Evidence map›Paper›PMID 40155002›Full record

Observational studyArchives of disease in childhood2025

Analysis of the asthma scores recommended in guidelines for children presenting to the emergency department: a Pediatric Emergency Research Networks study.

Charmaine Gray, Madeline Collings, Javier Benito, Roberto Velasco, Mark D Lyttle, Damian Roland, Suzanne Schuh, Bashar Shihabuddin, Maria Kwok, Prashant Mahajan and 14 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Archives of disease in childhood, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Charmaine GrayAdelaide Medical School, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia charmaine.gray2@sa.gov.au.ORCID 0000-0002-3625-6505
Madeline CollingsDepartment of Paediatrics, Monash University, Clayton, Victoria, Australia.
Javier BenitoPediatric Emergency Department, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Bilbao, Spain.
Roberto VelascoPediatric Emergency Unit, Hospital Universitari Parc Tauli, Institut d'Investigacio i Innovacio 13PT, Sabadell, Spain.ORCID 0000-0003-0073-2650
Mark D LyttleEmergency Department, Bristol Royal Hospital for Children, Bristol, UK.ORCID 0000-0002-8634-7210
Damian RolandSAPPHIRE Group, Population Health Sciences, Leicester University, Leicester, UK.ORCID 0000-0001-9334-5144
Suzanne SchuhPediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID 0000-0001-7567-6919
Bashar ShihabuddinDivision of Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
Maria KwokDepartment of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Prashant MahajanDepartment of Emergency Medicine and Pediatrics, University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
Mike JohnsonDepartment of Pediatrics, University of Utah Health, Salt Lake City, Utah, USA.
Joseph ZorcDivision of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Kajal KhannaDepartment of Emergency Medicine, School of Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
Adriana Yock-CorralesEmergency Department, Hospital Nacional de Ninos "Dr Carlos Saenz Herrera", CCSS, San Jose, Costa Rica.ORCID 0000-0002-8251-2434
Ricardo M FernandesFaculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Indumathy SanthanamPediatrc Emergency Medicine, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India.
Baljit CheemaDepartment of Paediatrics and Child Health, University of Cape Town Faculty of Health Sciences, Western Cape, South Africa.
Gene Yong-Kwang OngEmergency Medicine, KK Women's and Children's Hospital, Singapore.ORCID 0000-0002-9879-0594
Thiagarajan JaiganeshEmergency Department, Tawam Hospital, Al Ain, UAE.
Colin PowellDivision of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.ORCID 0000-0001-8181-875X
Stuart DalzielDepartment of Surgery and Paediatrics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand.
Franz E BablDepartments of Paediatrics and Critical Care, University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-1107-2187
Jennifer CouperWomen's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia.
Simon CraigMonash Medical Centre Clayton, Clayton, Victoria, Australia.ORCID 0000-0003-2594-1643

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleWhile there are numerous published paediatric asthma scores, it is unknown how commonly scores are recommended in asthma guidelines across different geographical regions globally, and what their validation status is.

objectives(1) To describe which clinical guidelines recommend asthma scores across different geographical regions. (2) To describe the initial and subsequent validation of the commonly recommended asthma scores.

methodsObservational study of asthma scores recommended in guidelines for the management of acute paediatric asthma from institutions across the Pediatric Emergency Medicine Network; global paediatric emergency medicine research network comprising all eight local and regional paediatric emergency medicine research networks. MAIN

results158 guidelines were identified. Overall, 83/158 (53%) guidelines recommend a bedside clinical score for assessment of asthma severity. While a single country-specific clinical score was recommended in all guidelines from Spain and Canada, 27/28 (96%) of the USA guidelines recommend a wide variety of scores, and scores are rarely recommended in guidelines from other research networks (PERUKI, Paediatric Emergency Research in the UK and Ireland and PREDICT, Paediatric Research in Emergency Departments International Collaborative in Australia and New Zealand) and other countries (Costa Rica, South Africa, Nigeria, Singapore, India).The Pediatric Respiratory Assessment Measure (PRAM) and the pulmonary score (PS) were the most frequently used scoring instruments. While the PRAM has undergone the most extensive validation, including construct validity, validation studies for the PS are limited. Inter-rater reliability, as well as the criterion, responsiveness and discriminative validity aspects represent the most common limitations in many of the scores.

conclusionsThere are marked geographical differences in both the recommendation for and the type of clinical asthma score in clinical practice guidelines. While many asthma scores are recommended, most have insufficient validation.

Indexed as

AsthmaEmergency Service, HospitalPractice Guidelines as TopicSeverity of Illness IndexChildChild, PreschoolHumansReproducibility of ResultsPaediatric Emergency MedicineRespiratory Medicine

Identifiers

PMID40155002
PMCPMC12171506

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.