Validation of the Asthma Severity Scoring System (ASSESS) in the ALLIANCE cohort

BACKGROUND: The Asthma Severity Scoring System (ASSESS) quantifies asthma severity in adolescents and adults. Scale performance in children < 12 years is unknown. OBJECTIVE: To validate the ASSESS score in the All Age Asthma Cohort (ALLIANCE) and explore its use in children <12 years. METHODS: Scale properties, responsiveness, and known-group validity were assessed in 247 children (median age 11 years, IQR: 8-13 years) and 206 adults (median age 52 years, IQR: 43-63 years). RESULTS: Overall, measures of internal test consistency and test-retest reliability were similar to the original data of the Severe Asthma Research Program (SARP). Cronbach's α was 0.59 in children 12-18 years and 0.73 in adults, reflecting the inclusion of multiple and not always congruent dimensions to the ASSESS score especially in children. Analysis of known-group validity confirmed the discriminatory power, as the ASSESS score was significantly worse in patients with poor asthma control, exacerbations and increased salbutamol use. In children between 6-11 years test reliability was inferior compared to adults and adolescents (Cronbach's α 0.27) mostly due to a less lung function impairment in asthmatic children of this age group. Known-group validity however confirmed good discriminative power regarding severity-associated variables similar to adolescents and adults. CONCLUSION: Test reliability and validity of the ASSESS score was confirmed in the ALLIANCE cohort. In children aged 6-11 years internal consistency was inferior compared to older asthma patients, however test validity was good and encourages age-spanning usage of the ASSESS score in all asthma patients ≥ 6 years.

• Grychtol, R.
• Riemann, L.
• Gaedcke, S.
• Liu, B.
• DeLuca, D.
• Förster, R.
• Maison, N.
• Thiele, D.
• Jakobs, N.
• Bahmer, T.
• Meyer, M.
• Foth, S.
• Weber, S.
• Rietschel, E.
• Rabe, K. F.
• Kopp, M. V.
• von Mutius, E.
• Dittrich, A. M.
• Hansen, G.