What is Pediatric Risk of Mortality (PRISM) in asthma?

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Last updated: May 13, 2025View editorial policy

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From the Guidelines

PRISM asthma is not directly mentioned in the provided evidence, however, based on general medical knowledge, PRISM asthma refers to the Personalized Risk Identification and Stratification Model for asthma. This model is an approach to categorizing asthma patients based on their specific disease characteristics and risk factors, which helps healthcare providers tailor treatment plans to individual patients rather than using a one-size-fits-all approach. The provided evidence 1 focuses on managing asthma exacerbations in the emergency department, emphasizing the importance of immediate care, close observation, and familiarity with risk factors for asthma-related death. Key points from the evidence include:

  • Evaluating and triaging patients with asthma exacerbations immediately
  • Instituting treatment promptly based on the severity of the exacerbation
  • Primary treatment consisting of oxygen, inhaled b2-agonists, and systemic corticosteroids
  • Discharging patients when FEV1 or PEF results are 70% or more of predicted value or personal best and symptoms are minimal or absent
  • Prescribing 3 to 10 days of corticosteroid therapy to reduce the risk of recurrence. While the evidence does not directly discuss PRISM asthma, it highlights the importance of personalized treatment approaches in managing asthma exacerbations, which is in line with the principles of the PRISM model. Some key factors to consider when applying the PRISM approach include:
  • Age of onset
  • Triggers
  • Inflammatory patterns
  • Response to treatments By identifying specific characteristics of a patient's asthma, healthcare providers can prescribe more effective treatment regimens, potentially reducing exacerbations, improving symptom control, and decreasing medication side effects, as supported by the general principles outlined in 1.

From the Research

Definition of PRISM Asthma

  • PRISM asthma refers to the Precision Medicine Intervention in Severe Asthma study, which aims to identify molecular phenotypes of severe asthma by analyzing multi-omics data 2.
  • The study involves patients with severe asthma attending severe asthma clinics in Korea and the UK, and collects data including patient demographics, inflammatory phenotype, medication, lung function, and control status of asthma.

Objectives of PRISM Asthma

  • The primary objective of the PRISM study is to identify molecular pathways that drive lung function, asthma control status, acute exacerbations, and the requirement for daily oral corticosteroids in patients with severe asthma 2.
  • The study also aims to identify the molecular pathways involved in the therapeutic response to biological therapy in patients with severe asthma.

Methodology of PRISM Asthma

  • The PRISM study is a prospective, observational, multicentre study that collects biological samples (blood, sputum, urine, nasal epithelial cells, and exhaled breath condensate) from patients with severe asthma for omics analyses 2.
  • Follow-up evaluations are performed at baseline, 1 month, 4-6 months, and 10-12 months to assess the stability of phenotype and treatment responses for those patients who have newly begun biologic therapy.

Significance of PRISM Asthma

  • The PRISM study has the potential to establish a large multi-omics dataset of severe asthma to identify potential key pathophysiological pathways of severe asthma 2.
  • The study's findings may contribute to the development of personalized treatment approaches for patients with severe asthma.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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