Ducharme Francine M, Chalut Dominic, Plotnick Laurie, Savdie Cheryl, Kudirka Denise, Zhang Xun, Meng Linyan, McGillivray David
Clinical Research Group on Childhood Asthma, Department of Pediatrics, McGill University Health Centre, Montreal, Quebec, Canada.
J Pediatr. 2008 Apr;152(4):476-80, 480.e1. doi: 10.1016/j.jpeds.2007.08.034. Epub 2007 Oct 31.
To determine the performance characteristics of the Preschool Respiratory Assessment Measure (PRAM) in preschool and school-aged children with acute asthma.
In a prospective cohort study, we examined the validity, responsiveness, and reliability of the PRAM in children aged 2 to 17 years with acute asthma. The study involved more than 100 nurses and physicians who recorded the PRAM on triage, after initial bronchodilation, and at disposition. Predictive validity and responsiveness were examined using disposition as outcome.
The PRAM was recorded in 81% (n = 782) of patients at triage. The PRAM at triage and after initial bronchodilation showed a strong association with admission (r = 0.4 and 0.5, respectively; P < .0001), thus supporting its ability to distinguish across severity levels. The responsiveness coefficient of 0.7 indicated good ability to identify change after bronchodilation. The PRAM showed good internal consistency (Cronbach alpha = 0.71) and inter-rater reliability (r = 0.78) for all patients and across all age groups.
Good performance characteristics were observed in all age groups, making the PRAM an attractive score for assessing asthma severity and response to treatment.
确定学龄前呼吸评估量表（PRAM）在患有急性哮喘的学龄前和学龄儿童中的性能特征。
在一项前瞻性队列研究中，我们检验了PRAM在2至17岁急性哮喘儿童中的有效性、反应性和可靠性。该研究涉及100多名护士和医生，他们在分诊时、初次支气管扩张后和出院时记录了PRAM。以出院情况作为结果来检验预测效度和反应性。
81%（n = 782）的患者在分诊时记录了PRAM。分诊时和初次支气管扩张后的PRAM与入院情况有很强的相关性（分别为r = 0.4和0.5；P <.0001），从而支持其区分不同严重程度水平的能力。反应系数为0.7表明其有良好的能力识别支气管扩张后的变化。PRAM在所有患者和所有年龄组中均显示出良好的内部一致性（Cronbach α = 0.71）和评分者间信度（r = 0.78）。
在所有年龄组中均观察到良好的性能特征，这使得PRAM成为评估哮喘严重程度和治疗反应的一个有吸引力的评分工具。
