Modified Asthma Predictive Index (mAPI)

The Modified Asthma Predictive Index (mAPI; criteria as validated by Chang and colleagues 2013), which predicts LATER asthma in preschool children who wheeze.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Wheezing episodes in the past year
5 episodes/year
MAJOR criterion. Parental physician-diagnosed asthma
Yes
MAJOR criterion. Physician-diagnosed atopic dermatitis
No
MAJOR criterion. Allergic sensitization to at least one…
No
MINOR criterion. Wheezing unrelated to colds
No
MINOR criterion. Blood eosinophils 4 percent or more
No
MINOR criterion. Allergic sensitization to milk
No

Result: mAPI POSITIVE

The tool opens with these values already filled in. Replace them with your own.

What the result means

Majors
Parental asthma; atopic dermatitis; aeroallergen sensitization.
Minors
Wheeze apart from colds; eosinophils 4% or more; milk/egg/peanut sensitization.
Not API+food
Allergic rhinitis was REMOVED from the original API minors. It is NOT a criterion here.
Denominators
API uses a 1-5 RATING SCALE; mAPI uses a literal COUNT. A rating of 3 is not 4 episodes.
Gate order
Criteria can NEVER substitute for the frequency gate.
Horizon
Applied at ages 1-3, validated against asthma at 6, 8 and 11, in a HIGH-RISK cohort.
Scope
Does not diagnose or exclude asthma. NOT an indication to start inhaled corticosteroids.

What you enter

  • Wheezing episodes in the past year.
  • MAJOR criterion.
  • MAJOR criterion.
  • MAJOR criterion.
  • MINOR criterion.
  • MINOR criterion.
  • MINOR criterion.
  • Optional blood eosinophil percentage.
Full field descriptions
  • Wheezing episodes in the past year. A literal COUNT, gating at 4 or more. NOT the original API's 1-to-5 rating scale.
  • MAJOR criterion. Parental physician-diagnosed asthma
  • MAJOR criterion. Physician-diagnosed atopic dermatitis
  • MAJOR criterion. Allergic sensitization to at least one aeroallergen ADDED in the mAPI; not in the original API.
  • MINOR criterion. Wheezing unrelated to colds
  • MINOR criterion. Blood eosinophils 4 percent or more
  • MINOR criterion. Allergic sensitization to milk, egg, or peanut REPLACED allergic rhinitis, which was removed from the original API and is NOT scored here.
  • Optional blood eosinophil percentage. If supplied it DECIDES the eosinophil criterion, which is 4 percent OR MORE, so exactly 4.0 meets it.
How this is calculated
Structure
NOT a score. A two-gate boolean: 4+ episodes/year AND (1+ major OR 2+ minor).

Chang TS, Lemanske RF Jr, Guilbert TW, et al. Evaluation of the Modified Asthma Predictive Index in High-Risk Preschool Children. J Allergy Clin Immunol Pract. 2013;1(2):152-156. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.