Calculators & Tools

Modified API (mAPI)

Modified Asthma Predictive Index - adds aeroallergen and food sensitisation.

1 What is the Modified API (mAPI)?

The Modified API (mAPI) is a respiratory scoring tool used in paediatric practice. Modified Asthma Predictive Index - adds aeroallergen and food sensitisation. It scores 7 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in respiratory
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 7 criteria: ≥4 wheezing episodes in the past year, at least one physician-confirmed (required); MAJOR - parental history of asthma; MAJOR - physician-diagnosed atopic dermatitis; MAJOR - sensitisation to ≥1 aeroallergen; MINOR - wheezing apart from colds; MINOR - blood eosinophilia ≥ 4 %; MINOR - sensitisation to milk, egg or peanut. Totals are then banded: any score - Negative: requires ≥4 wheezing episodes/year PLUS ≥1 major OR ≥2 minor criteria; 6 criteria or more - Positive mAPI: positive mAPI - increased likelihood of persistent asthma. Used as an entry criterion in several paediatric asthma trials.
  • Source: 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;114:1282-7.

4 Frequently asked questions

How many criteria does the Modified API (mAPI) use?

7. They are ≥4 wheezing episodes in the past year, at least one physician-confirmed (required); MAJOR - parental history of asthma; MAJOR - physician-diagnosed atopic dermatitis; MAJOR - sensitisation to ≥1 aeroallergen; MINOR - wheezing apart from colds; MINOR - blood eosinophilia ≥ 4 %; and others.

What do the bands of the Modified API (mAPI) mean?

The total is interpreted as: any score - Negative: requires ≥4 wheezing episodes/year PLUS ≥1 major OR ≥2 minor criteria; 6 criteria or more - Positive mAPI: positive mAPI - increased likelihood of persistent asthma. Used as an entry criterion in several paediatric asthma trials.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Source: 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;114:1282-7.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.