Clinical Report: Comprehensive Nomogram for Inadequate Asthma Management

Overview

This study developed and validated a nomogram integrating PIV, LDH, and FeNO to predict inadequate asthma management in pediatric patients. The model demonstrated superior predictive performance compared to individual biomarkers.

Background

Asthma is a prevalent chronic condition in children, often leading to poor control despite guideline-based treatments. Traditional assessment tools have limitations, necessitating the exploration of objective biomarkers for better risk stratification.

Data Highlights

Key Findings

• Six independent predictors of poor asthma control were identified: PIV, LDH, FeNO, Vitamin D, asthma duration, and FEV1% predicted.
• The combined model achieved an AUC of 0.886.
• PIV, LDH, FeNO, and asthma duration were identified as risk factors for poor asthma control.
• Vitamin D and FEV1% predicted were found to be protective factors.
• The nomogram showed good calibration.

Clinical Implications

The integration of multiple biomarkers into a nomogram may enhance the identification of children at risk for poor asthma control. This approach supports personalized management strategies in pediatric asthma care.

Conclusion

The study presents a multidimensional model that effectively stratifies risk for poor asthma control in children, potentially aiding in tailored management strategies.

Related Resources & Content

1. Frontiers in Pediatrics, 2026 -- A Decade-Long Real-World Cohort (2016-2025): Development of an Individualized Risk-Stratification Nomogram and Evaluation of Clinical Utility for Recurrent Respiratory Tract Infections in Children
2. Frontiers in Pediatrics, 2026 -- Advancements in diagnosis, preventive care, and future directions in the holistic management of pediatric asthma
3. 2026 GINA Strategy Report - Global Initiative for Asthma - GINA
4. Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) - NCBI Bookshelf
5. Pediatric Cardiology — Assessing Lung Function in Fontan Patients Over a Decade: Does the Fontan Circulation Hinder Pulmonary Development?
6. Frontiers in Medicine — Nomograms to predict severe PH and survival in COPD patients using non-invasive parameters
7. ERS technical standard: Global Lung Function Initiative reference values for exhaled nitric oxide fraction (FENO50) | European Respiratory Society
8. Scientific summary - Treatment guided by fractional exhaled nitric oxide in addition to standard care in 6- to 15-year-olds with asthma: the RAACENO RCT - NCBI Bookshelf
9. 2026 GINA Strategy Report - Global Initiative for Asthma - GINA
10. Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) - NCBI Bookshelf
11. Evidence reviews for FeNO measures to monitor asthma - NCBI Bookshelf
12. Blood eosinophils and fractional exhaled nitric oxide are prognostic and predictive biomarkers in childhood asthma - ScienceDirect
13. Distinguishing Childhood Asthma Exacerbations from Stable Asthma: The Utility of Inflammatory White Blood Cell Biomarkers | MDPI
14. The role of 14-3-3β in acute asthma in children and analysis of the risk factors for asthma exacerbation - PubMed
15. Investigating Machine Learning Techniques for Predicting Risk of Asthma Exacerbations: A Systematic Review | Journal of Medical Systems | Springer Nature Link