Modified Asthma Predictive Index (mAPI)

Why Use

A standardized score for determining which children are at higher risk for development of asthma may improve care or disease detection, possibly better than the Asthma Predictive Index (API) .

When to Use

Children ≤3 years old with known wheezing.

Formula

Pearls / Pitfalls

The Modified Asthma Predictive Index (mAPI) provides a method for predicting likelihood of a later asthma diagnosis. It is only applicable in young children with 4 or more episodes of wheezing per year. The mAPI’s predictive ability depends heavily on prevalence of asthma in the general population.

Advice

Unfortunately, while the mAPI was used successfully to identify high asthma risk children in a randomized trial, there was no long term benefit found from inhaled corticosteroids on the development of asthma or lung function.

More Information

Sensitivity and specificity for positive predictions of asthma by year of life Year Sensitivity (95% CI) Specificity (95% CI) Age 6 asthma diagnosis 1 11% (4.2–19) 98% (96–100) 2 12% (4.2–19) 99% (98–100) 3 17% (8.4–25) 99% (98–100) Age 8 asthma diagnosis 1 8.2% (2.2–14) 98% (97–100) 2 11% (3.9–18) 99% (98–100) 3 19% (8.8–25) 100% (99–100) Age 11 asthma diagnosis 1 11% (3.6–18) 98% (95–100) 2 11% (3.6–19) 98% (96–100) 3 19% (9.3–28) 99% (97–100)