Aims and Objectives: Numerous risk scores have been developed to predict childhood asthma.  However, they may not predict asthma beyond childhood. We aim to create childhood risk scores that predict development and persistence of asthma up to young adult life.

Methods: The Isle of Wight Birth Cohort (n=1456) was prospectively assessed up to 26-years of age. Asthma predictive scores were developed based on factors during the first 4-years, using logistic regression and tested for sensitivity, specificity, and area under the curve (AUC) for prediction of asthma at (i) 18 and (ii) 26-years, and persistent asthma (PA) (iii) at 10 and 18 years, and (iv) at 10, 18 and 26 years. Models were internally and externally validated.

Results: Four models were generated for prediction of each asthma outcome. ASthma PredIctive Risk scorE (ASPIRE)-1: a 2-factor model (recurrent wheeze [RW] and positive skin prick test [+SPT] at 4-years) predicted asthma at 18-years (sensitivity: 0.49, specificity: 0.80, AUC: 0.65). ASPIRE-2: a 3-factor model (RW, +SPT and maternal rhinitis) predicted asthma at 26-years (sensitivity: 0.60, specificity: 0.79, AUC: 0.73). ASPIRE-3: a 3-factor model (RW, +SPT and eczema at 4-years) predicted PA-18 (sensitivity: 0.63, specificity: 0.87, AUC: 0.77). ASPIRE-4: a 3-factor model (RW, +SPT at 4-years and recurrent chest infection at 2-years) predicted PA-26 (sensitivity: 0.68, specificity: 0.87, AUC: 0.80). ASPIRE-1 and ASPIRE-3 scores were replicated externally. Further assessments indicated that ASPIRE-1, a 2-factor model (RW and +SPT) can be applied to predict all 4 asthma outcomes.

Conclusion: ASPIRE predicts persistent asthma up to young adult life.