Asthma Scoring Systems

Sir .—In the February 1988 issue of AJDC , Baker 1 reported that the asthma scoring system of Wood et al 2 failed to relate to outcomes of episodes of childhood asthma treated in the emergency room. As he emphasized, the system was originally devised to select children with respiratory failure, so its poor showing in the emergency room context was not surprising. What is sadly remarkable is how widely this scoring system has been adopted, uncritically, for the assessment of childhood asthma in various clinical settings. Equally sad is the absence of any other adequately tested clinical scoring system, although other indexes have been supported by limited data, 3,4 and some clinical signs have been related to levels of airway obstruction 5 and even to outcomes of emergency room encounters. 6 By contrast, quantitative measurements of pulmonary function are related closely to the severity of obstruction and the response to