Modified Asthma Predictive Index (mAPI) for Children
Identifies young children (≤ 3 years) with recurrent wheeze at high risk of persistent asthma at school age. Modified API (PEAK trial / COAST cohort) of the original Tucson Asthma Predictive Index.
Score interpretation
API negative -- low probability of persistent asthma by school age
→ Reassurance: most early wheezers do not have persistent asthma; avoid unnecessary inhaled corticosteroids; short-acting bronchodilator via spacer for acute episodes; re-evaluate if the pattern changes.
mAPI positive — markedly higher likelihood of asthma at school age (Chang 2013).
→ Discuss asthma likelihood with the family; consider a trial of inhaled corticosteroid via spacer at a dose from a children's formulary; reliever via spacer as needed; allergy assessment; written asthma action plan; review with the paediatric respiratory team if poorly controlled.
Interpretation bands for the Asthma Predictive Index. Apply clinical judgement and local guidance.
References
- Castro-Rodriguez JA, et al. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. 2000;162(4):1403–1406.
- Guilbert TW, et al. Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma. J Allergy Clin Immunol. 2004;114(6):1282–1287.
- Chang TS, et al. Evaluation of the modified asthma predictive index in high-risk preschool children. J Allergy Clin Immunol Pract. 2013;1(2):152–156.
- NICE NG245. Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN). 2024.
Related
Curated clinical cross-links plus same-class fallbacks.
- Salbutamol (Paediatric — Asthma/Wheeze) · Short-Acting Beta-2 Agonist (SABA)
- Ibuprofen (Paediatric) · NSAID / Analgesic / Antipyretic
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Prednisolone (Paediatric) · Corticosteroid — Asthma Exacerbation / Croup / Nephrotic Syndrome / IBD
- Montelukast (Paediatric) · Leukotriene Receptor Antagonist — Asthma Prophylaxis / Allergic Rhinitis
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
