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Chantaphakul H, Wang DY, Hang TTT, Kadir KA, Lam HT, Navarro-Locsin CG, Nanthapisal S, Poblete D, Tantilipikorn P, Tong WH, Nagrale D, Lucas M. Promoting patient-centred care in the management of allergic rhinitis in Asia-Pacific countries. World Allergy Organ J 2024; 17:100952. [PMID: 39262901 PMCID: PMC11388691 DOI: 10.1016/j.waojou.2024.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/17/2024] [Accepted: 07/30/2024] [Indexed: 09/13/2024] Open
Abstract
Background Allergic rhinitis (AR) has a high burden of disease in the Asia-Pacific region (APAC). Although guidelines provide recommendations regarding the diagnosis and treatment of AR, it is increasingly being recognised that there are gaps in their implementation. Patient-centred care involves accounting for the specific needs and desires of patients as well as including the patient in the decision-making process, and this may provide a means to reduce these gaps and consequently the burden of AR. Methods A group of 11 experts in immunology and otorhinolaryngology from APAC provided information regarding their practices and experiences in the management of AR through an online survey. The group then discussed the barriers and solutions for the implementation of patient-centred care across the patient journey in a face-to-face meeting. Results Key barriers to the implementation of patient-centred care for AR in APAC included a lack of patient awareness of the condition and treatment options, low adherence to treatments, financial constraints for patients, and time constraints for physicians. The solutions proposed include improving the knowledge of the patients about their conditions, the use of shared decision-making, the consideration of patient characteristics when choosing treatments, and the use of outcome measures to aid the optimisation of patient care. We provide specific recommendations for clinical practice. Conclusion A greater focus on patient-centred approaches has the potential to improve the management of AR in APAC. More emphasis should be placed on each patient's specific health needs and desired outcomes.
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Affiliation(s)
- Hiroshi Chantaphakul
- Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Hoang Thi Lam
- Unit of Allergy and Clinical Immunology, University Medical Center, Ho Chi Minh City, Viet Nam
| | | | - Sira Nanthapisal
- Division of Allergy, Immunology, and Rheumatology, Thammasat University, Pathumthani, Thailand
| | | | - Pongsakorn Tantilipikorn
- Center of Research Excellence in Allergy & Immunology, Faculty of Medicine, Siriraj Hospital, Thailand
| | | | | | - Michaela Lucas
- Department of Immunology, QE Medical Centre, Sir Charles Gairdner Hospital, Perth Children's Hospital, University of Western Australia, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
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Vieira RJ, Azevedo LF, Pereira AM, Nogueira-Leite D, Rocha Gonçalves FN, Larenas-Linnemann DE, Cruz AA, Gemicioglu B, Samolinski B, de Las Vecillas L, Giovannini M, Cunha MJ, Rodrigues J, Kvedariene V, Klimek L, Pfaar O, Zuberbier T, Fonseca JA, Bousquet J, Sousa-Pinto B. Impact of Allergic Rhinitis Control on Work Productivity and Costs: A Real-World Data MASK-air Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00776-1. [PMID: 39111363 DOI: 10.1016/j.jaip.2024.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/16/2024] [Accepted: 07/22/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Allergic rhinitis (AR) has a substantial socioeconomic impact associated with impaired work productivity. OBJECTIVE To study the impact of AR on work productivity and estimate the corresponding indirect costs for 40 countries. METHODS We conducted a cross-sectional study using direct patient data from the MASK-air app on users with self-reported AR. We used the Work Productivity and Activity Impairment Questionnaire: Allergy Specific to measure the impact of AR on work productivity (presenteeism and absenteeism). Weekly indirect costs were estimated per country for each level of rhinitis control. Patients with and without asthma were considered. RESULTS We assessed data from 677 weeks (364 patients), 280 of which were reported by patients with asthma. Regarding presenteeism, the median impact of AR in weeks of poor disease control was 60.7% (percentiles 25-75 [P25-P75] 24.9%-74.2%), whereas partial and good disease control were, respectively, associated with an impact of 25.0% (P25-P75 12.1%-42.4%) and 4.4% (P25-P75 0.8%-12.9%). In poorly controlled weeks, presenteeism was associated with indirect costs ranging from 65.7 US$ purchase power parities (PPPs) (P25-P75 29.2-143.2) in Brazil to 693.6 US$ PPP (P25-P75 405.2-1,094.9) in Iceland. Median absenteeism per week was of 0% for all levels of rhinitis control. Patients with AR + asthma showed higher overall work impairment than patients with AR alone, particularly in poorly controlled weeks (median work impairment in AR alone 39.1% [P25-P75 12.5%-71.9%]; median work impairment in AR + asthma 68.4% [P25-P75 54.6%-80.2%]). CONCLUSIONS Poor AR control was associated with decreased work productivity and increased indirect costs, particularly in patients with AR + asthma. The estimates from this study underpin the economic burden of AR.
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Affiliation(s)
- Rafael José Vieira
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luís Filipe Azevedo
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Margarida Pereira
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; PaCeIT-Patient Centered Innovation and Technologies, Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal; Allergy Unit, Institute and Hospital Companhia União Fabril (CUF) (Instituto and Hospital Companhia União Fabril - CUF), Porto, Portugal
| | - Diogo Nogueira-Leite
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Francisco Nuno Rocha Gonçalves
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Desirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, Mexico City, Mexico
| | - Alvaro A Cruz
- PROfessionals of Asthma and Respiratory Foundation (Fundaçao ProAR), Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey; Institute of Pulmonology and Tuberculosis, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Leticia de Las Vecillas
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital - Istituto di Ricovero e Cura a Carattere Scientifico - IRCCS (Scientific Institute for Hospitalization and Care), Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
| | - Maria João Cunha
- Amadeo de Souza-Cardoso Family Health Unit, Tâmega I Health Center Group (Unidade de Saúde Familiar Amadeo de Souza-Cardoso, Agrupamento de Centros de Saúde Tâmega I), Amarante, Portugal
| | - Jorge Rodrigues
- CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal; Otorhinolaryngology Department, Sao Joao University Hospital Center (Centro Hospitalar Universitário de Sao João), Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Violeta Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, University Medicine of Mainz (Universitätsmedizin Mainz), Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Torsten Zuberbier
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - João A Fonseca
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Inserm Equipe d'Epidémiologie Respiratoire Intégrative, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Villejuif, France; Allergic Rhinitis and its Impact on Asthma (ARIA), Montpellier, France; MASK-air, Montpellier, France.
| | - Bernardo Sousa-Pinto
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
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3
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Vieira RJ, Leemann L, Schünemann HJ, Azevedo LF, Fonseca JA, Bousquet J, Sousa-Pinto B. Impact of Uncontrolled Symptoms on the Health-Related Quality of Life (EQ-5D-5L) of Patients With Allergic Rhinitis: A MASK-air Study. Clin Exp Allergy 2024; 54:634-637. [PMID: 39031606 DOI: 10.1111/cea.14516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/14/2024] [Accepted: 05/26/2024] [Indexed: 07/22/2024]
Affiliation(s)
- Rafael José Vieira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Lucas Leemann
- Department of Political Science, University of Zurich, Zurich, Switzerland
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luís Filipe Azevedo
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - João A Fonseca
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
- MASK-Air SAS, Montpellier, France
| | - Bernardo Sousa-Pinto
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
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4
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Bousquet J, Sousa-Pinto B, Anto JM, Bedbrook A, Fonseca JA, Zuberbier T. MASK-air: An OECD (Organisation for Economic Co-operation and Development) Best Practice for Public Health on Integrated Care for Chronic Diseases. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2010-2016.e7. [PMID: 38521122 DOI: 10.1016/j.jaip.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/17/2024] [Accepted: 03/09/2024] [Indexed: 03/25/2024]
Abstract
In the recent report of the Organisation for Economic Co-operation and Development (OECD) on Best Practices (BPs) for Integrating Care to Prevent and Manage Chronic Diseases, an app on rhinitis and asthma (MASK-air [Mobile Airways Sentinel networK for airway diseases]) has been listed. The OECD is a reliable source of evidence-based policy analysis and economic data largely used by governments. It has published several BPs on public health. On May 10, 2023, the OECD published 13 BPs for Integrating Care to Prevent and Manage Chronic Diseases in the European Union. The report did not cover all models of integrated care; rather, it "focuse(d) on those that are of key strategic interest to policy makers." New MASK-air studies (not published in the report) include equity, usability of the app in old-age adults, economic impact, quality of life, and allergen immunotherapy. MASK-air is freely available on iOS and Android in 30 countries and has been recently introduced in the United States. The MASK-air OECD BP represents a model of digitally enabled, patient-centered care for chronic diseases using a holistic approach of shared decision making.
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Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; MASK-air, Montpellier, France; ARIA, Montpellier, France.
| | - Bernardo Sousa-Pinto
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Anna Bedbrook
- MASK-air, Montpellier, France; ARIA, Montpellier, France
| | - Joao A Fonseca
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
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5
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Bousquet J, Schünemann HJ, Sousa-Pinto B, Zuberbier T, Togias A, Samolinski B, Bedbrook A, Czarlewski W, Hofmann-Apitius M, Litynska J, Vieira RJ, Anto JM, Fonseca JA, Brozek J, Bognanni A, Brussino L, Canonica GW, Cherrez-Ojeda I, Cruz AA, Vecillas LDL, Dykewicz M, Gemicioglu B, Giovannini M, Haahtela T, Jacobs M, Jacomelli C, Klimek L, Kvedariene V, Larenas-Linnemann DE, Louis G, Lourenço O, Leemann L, Morais-Almeida M, Neves AL, Nadeau KC, Nowak A, Palamarchuk Y, Palkonen S, Papadopoulos NG, Parmelli E, Pereira AM, Pfaar O, Regateiro FS, Savouré M, Taborda-Barata L, Toppila-Salmi SK, Torres MJ, Valiulis A, Ventura MT, Williams S, Yepes-Nuñez JJ, Yorgancioglu A, Zhang L, Zuberbier J, Abdul Latiff AH, Abdullah B, Agache I, Al-Ahmad M, Al-Nesf MA, Al Shaikh NA, Amaral R, Ansotegui IJ, Asllani J, Balotro-Torres MC, Bergmann KC, Bernstein JA, Bindslev-Jensen C, Blaiss MS, Bonaglia C, Bonini M, Bossé I, Braido F, Caballero-Fonseca F, Camargos P, Carreiro-Martins P, Casale T, Castillo-Vizuete JA, Cecchi L, Teixeira MDC, Chang YS, Loureiro CC, Christoff G, Ciprandi G, Cirule I, Correia-de-Sousa J, Costa EM, Cvetkovski B, de Vries G, Del Giacco S, Devillier P, Dokic D, Douagui H, Durham SR, Enecilla ML, Fiocchi A, Fokkens WJ, Fontaine JF, Gawlik R, Gereda JE, Gil-Mata S, Giuliano AFM, Gotua M, Gradauskiene B, Guzman MA, Hossny E, Hrubiško M, Iinuma T, Irani C, Ispayeva Z, Ivancevich JC, Jartti T, Jeseňák M, Julge K, Jutel M, Kaidashev I, Bennoor KS, Khaltaev N, Kirenga B, Kraxner H, Kull I, Kulus M, Kuna P, Kupczyk M, Kurchenko A, La Grutta S, Lane S, Miculinic N, Lee SM, Le Thi Tuyet L, Lkhagvaa B, Louis R, Mahboub B, Makela M, Makris M, Maurer M, Melén E, Milenkovic B, Mohammad Y, Moniuszko M, Montefort S, Moreira A, Moreno P, Mullol J, Nadif R, Nakonechna A, Navarro-Locsin CG, Neffen HE, Nekam K, Niedoszytko M, Nunes E, Nyembue D, O'Hehir R, Ollert M, Ohta K, Okamoto Y, Okubo K, Olze H, Padukudru MA, Palomares O, Pali-Schöll I, Panzner P, Palosuo K, Park HS, Passalacqua G, Patella V, Pawankar R, Pétré B, Pitsios C, Plavec D, Popov TA, Puggioni F, Quirce S, Raciborski F, Ramonaité A, Recto M, Repka-Ramirez S, Roberts G, Robles-Velasco K, Roche N, Rodriguez-Gonzalez M, Romualdez JA, Rottem M, Rouadi PW, Salapatas M, Sastre J, Serpa FS, Sayah Z, Scichilone N, Senna G, Sisul JC, Solé D, Soto-Martinez ME, Sova M, Sozinova O, Stevanovic K, Ulrik CS, Szylling A, Tan FM, Tantilipikorn P, Todo-Bom A, Tomic-Spiric V, Tsaryk V, Tsiligianni I, Urrutia-Pereira M, Rostan MV, Sofiev M, Valovirta E, Van Eerd M, Van Ganse E, Vasankari T, Vichyanond P, Viegi G, Wallace D, Wang DY, Waserman S, Wong G, Worm M, Yusuf OM, Zaitoun F, Zidarn M. Concepts for the Development of Person-Centered, Digitally Enabled, Artificial Intelligence-Assisted ARIA Care Pathways (ARIA 2024). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00682-2. [PMID: 38971567 DOI: 10.1016/j.jaip.2024.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/16/2024] [Accepted: 06/25/2024] [Indexed: 07/08/2024]
Abstract
The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own lives based on their lived experiences. Improving healthcare safety, quality, and coordination, as well as quality of life, is an important aim in the care of patients with chronic conditions. Person-centered care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (1) digital care pathways for rhinitis and asthma multimorbidity and (2) digitally enabled, person-centered care.1 It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally enabled, patient-centered care. The paper includes (1) Allergic Rhinitis and its Impact on Asthma (ARIA), a 2-decade journey, (2) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (3) mHealth impact on airway diseases, (4) From guidelines to digital care pathways, (5) Embedding Planetary Health, (6) Novel classification of rhinitis and asthma, (7) Embedding real-life data with population-based studies, (8) The ARIA-EAACI (European Academy of Allergy and Clinical Immunology) strategy for the management of airway diseases using digital biomarkers, (9) Artificial intelligence, (10) The development of digitally enabled, ARIA person-centered care, and (11) The political agenda. The ultimate goal is to propose ARIA 2024 guidelines centered around the patient to make them more applicable and sustainable.
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Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; ARIA, Montpellier, France.
| | - Holger J Schünemann
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada; Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Bernardo Sousa-Pinto
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Md
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Martin Hofmann-Apitius
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Bonn, Germany
| | - Justyna Litynska
- Evidence Prime, Kracow, Poland; Gynecological and Obstetrician Polyclinic, District Hospital, Białystok, Poland
| | - Rafael José Vieira
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Department of Experimental Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; Department of Epidemiology & Public Health, CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Joao A Fonseca
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jan Brozek
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Antonio Bognanni
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, Evidence in Allergy group, McMaster University, Hamilton, ON, Canada
| | - Luisa Brussino
- Department of Medical Sciences, University of Torino, Torino, Italy; Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy
| | - G Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Asthma & Allergy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ivan Cherrez-Ojeda
- Research Center 'Respiralab', Universidad Espíritu Santo, Samborondón, Ecuador; Department of Allergology & Pulmonology, Respiralab Research Group, Guayaquil, Guayas, Ecuador
| | - Alvaro A Cruz
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - Leticia de Las Vecillas
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Mark Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Mo
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, and Institute of Pulmonology & Tuberculosis, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Mattia Giovannini
- Department of Health Sciences, University of Florence, Florence, Italy; Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Marc Jacobs
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Bonn, Germany
| | - Cristina Jacomelli
- "Respiriamo Insieme" Association, Asthma & Allergy Center, Padova, Italy
| | - Ludger Klimek
- Department of Otolaryngology, Head & Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Allergology & Rhinology Department, Wiesbaden, Germany
| | - Violeta Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Desiree E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Gilles Louis
- Department of Public Health, University of Liège, Liège, Belgium
| | - Olga Lourenço
- Faculty of Health Sciences and CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Lucas Leemann
- Department of Political Science, University of Zürich, Zürich, Switerland
| | | | - Ana Luisa Neves
- Global Digital Health Unit, Department of Primary Care and Public Health, Imperial College, London, United Kingdom
| | - Kari C Nadeau
- Department of Environmental Health, Harvard TH Chan School of Public Health and Department of Medicine, Division of Allergy and Inflammation, Beth Israel Deaconess Hospital, Boston, Mass
| | - Artur Nowak
- Evidence Prime, Kracow, Poland; Gynecological and Obstetrician Polyclinic, District Hospital, Białystok, Poland
| | - Yuliia Palamarchuk
- Finnish Meteorological Institute (FMI), Atmospheric Composition Research, Helsinki, Finland
| | - Susanna Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | | | - Elena Parmelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Asthma & Allergy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ana Margarida Pereira
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; PaCeIT-Patient Centered Innovation and Technologies, Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal; Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; UBIAir-Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Marine Savouré
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Luis Taborda-Barata
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal; UBIAir-Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Sanna K Toppila-Salmi
- Department of Allergy, Skin and Allergy Hospital, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Otorhinolaryngology, University of Eastern Finland and the North Savo Wellbeing Services County, Kuopio, Finland
| | - Maria J Torres
- Allergy Unit, Málaga Regional University Hospital of Málaga, Malaga University, ARADyAL, Malaga, Spain
| | - Arunas Valiulis
- Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania; Clinic of Asthma, Allergy, and Chronic Lung Diseases, Asthma & Allergy Department, Vilnius, Lithuania
| | - Maria Teresa Ventura
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy; Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
| | - Sian Williams
- International Primary Care Respiratory Group IPCRG, Edinburgh, United Kingdom
| | - Juan J Yepes-Nuñez
- School of Medicine, Universidad de los Andes, Bogotá, DC, Colombia; Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá, University Hospital, Bogotá, DC, Colombia
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China
| | - Jaron Zuberbier
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Maryam Ali Al-Nesf
- Adult Allergy and Immunology Division-Hamad Medical Corporation, Doha, Qatar
| | - Nada A Al Shaikh
- Otolaryngology Head & Neck Surgery Department, Mouwasat Hospital, Dammam, Saudi Arabia
| | - Rita Amaral
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal; Department of Women's and Children's Health, Paediatric Research, Uppsala University, Uppsala, Sweden
| | - Ignacio J Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | - Julijana Asllani
- Department of Internal Medicine, University of Medicine, Tirana, Albania
| | | | - Karl-Christian Bergmann
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Jonathan A Bernstein
- Division of Immunology, Allergy and Rheumatology, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Center, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Michael S Blaiss
- Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Ga
| | - Cristina Bonaglia
- Institute "Bona Sforza", University for Linguistic Mediators, Bari, Italy
| | - Matteo Bonini
- Department of Cardiovascular and Respiratory Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Neurological, ENT and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli-IRCCS, Rome, Italy; National Heart and Lung Institute (NHLI), Imperial College London, London, United Kingdom
| | | | - Fulvio Braido
- Respiratory Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy; Respiratory & Allergy Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Paulo Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Pedro Carreiro-Martins
- NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal; Serviço de Imunoalergologia, Centro Hospitalar Universitário de Lisboa Central/ULS São José, Lisbon, Portugal
| | - Thomas Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, Fla
| | - José-Antonio Castillo-Vizuete
- Department of Respiratory Medicine, Hospital Universitari Dexeus, Barcelona, Spain; The Group of Rhinitis, Rhinosinusitis and Nasal Polyps, Area of Asthma, SEPAR, Barcelona, Spain
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Maria do Ceu Teixeira
- Dr Agostinho Neto University hospital, Epidemiology Department, Praia, Cabo Verde; Immunology, Cabo Verde University, Faculty of Medicine, Praia, Cabo Verde
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Claudia Chaves Loureiro
- Department of Pneumology, Coimbra University Hospital, Faculty of Medicine, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research, CIBB, Coimbra, Portugal
| | - George Christoff
- Faculty of Public Health, Sofia Medical University, Sofia, Bulgaria
| | - Giorgio Ciprandi
- Casa di Cura Villa Montallegro, Allergology Department, Genova, Italy
| | - Ieva Cirule
- Latvian Association of Allergists, University Children Hospital, Riga, Latvia
| | - Jaime Correia-de-Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Elisio M Costa
- CINTESIS@RISE, Biochemistry Lab, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto, Porto, Portugal
| | - Biljana Cvetkovski
- Woolcock Institute of Medical Research, Quality Use of Respiratory Medicine, Sydney, NSW, Australia
| | | | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
| | - Philippe Devillier
- VIM Suresnes, UMR 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | - Dejan Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic of Macedonia
| | - Habib Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algiers, Algeria
| | - Stephen R Durham
- Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | | | - Alessandro Fiocchi
- Allergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
| | | | - Radoslaw Gawlik
- Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jose E Gereda
- Clínica Ricardo Palma, Allergy & Immunology Department, Lima, Peru
| | - Sara Gil-Mata
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Antonio F M Giuliano
- Department of Internal Medicine 'A. Murri' and Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - Maia Gotua
- Center of Allergy and Immunology, David Tvildiani Medical University, Tbilisi, Georgia
| | - Brigita Gradauskiene
- Department of Immunology and Allergology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Maria Antonieta Guzman
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - Elham Hossny
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Martin Hrubiško
- Department of Clinical Immunology and Allergy, Oncology Institute of St Elisabeth, Bratislava, Slovakia
| | - Tomohisa Iinuma
- Department of Otorhinolaryngology, Chiba University, Chiba, Japan
| | - Carla Irani
- Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Zhanat Ispayeva
- Department of Allergology and Clinical Immunology, Kazakhstan Association of Allergology and Clinical Immunology, Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Tuomas Jartti
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Pediatrics and Adolescent Medicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Miloš Jeseňák
- Department of Pulmonology and Phthisiology, Department of Pediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovakia; Institute of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovakia
| | - Kaja Julge
- Institute of Clinical Medicine, Children's Clinic, Tartu University, Tartu, Estonia
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland; ALL-MED Medical Research Institute, Department of Clinical Immunology, Wroclaw, Poland
| | - Igor Kaidashev
- Poltava State Medical University, Immunology & Allergology Department, Poltava, Ukraine
| | - Kazi S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | | | - Bruce Kirenga
- Makerere University Lung Institute, Pulmonology Medicine Department, Kampala, Uganda
| | - Helga Kraxner
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Marek Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Andriy Kurchenko
- Department of Clinical and Laboratory Immunology, Allergology and Medical Genetics, Bogomolets National Medical University, Kyiv, Ukraine
| | - Stefania La Grutta
- Institute of Translational Pharmacology (IFT)-National Research Council (CNR), Palermo, Italy
| | - Stephen Lane
- Respiratory Medicine, Trinity College, Dublin, Ireland; Respiratory Physician & Allergist, Professorial Respiratory Centre, Tallaght University Hospital & Peamount Healthcare, Dublin, Ireland
| | - Neven Miculinic
- Croatian Pulmonary Society, Clinical Center for Pulmonary Diseases, Zagreb, Croatia
| | - Sang Min Lee
- Dankook University Hospital, ENT Department, Cheonan, Republic of Korea
| | - Lan Le Thi Tuyet
- Asthma, COPD Outpatient Care Unit, University Medical Center, Hô-Chi-Minh City, Vietnam
| | - Battur Lkhagvaa
- Mongolian National University of Medical Sciences, Health Department, Ulan Bator, Mongolia
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Liège, Liège, Belgium; GIGA I3 Research Group, University of Liège, Liège, Belgium
| | - Bassam Mahboub
- Rashid Hospital, DUBAI Health, Dubai, UAE; Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| | - Mika Makela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Michael Makris
- Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Eric Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Branislava Milenkovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - Yousser Mohammad
- National Center for Research in Chronic Respiratory Diseases, Collaborating with WHO-EMRO Tishreen University School of Medicine, Latakia, Syria; Al-Sham Private University, Pharmacy Department, Damascus, Syria
| | - Marcin Moniuszko
- Department of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Stephen Montefort
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, MSD, Malta
| | - Andre Moreira
- EPIUnit-Institute of Public Health, University of Porto, and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, Porto, Portugal; Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain; Clinical & Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - Rachel Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France; Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
| | - Alla Nakonechna
- Clinical Immunology and Allergy Unit, Sheffield Teaching Hospitals, Sheffield, United Kingdom; University of Liverpool, Liverpool, United Kingdom
| | - Cecilia Gretchen Navarro-Locsin
- Department of Otolaryngology-Head & Neck Surgery, St Luke's Medical Center, Quezon City, Philippines; Division of Surgery, Philippine Children's Medical Center, Quezon City, Philippines
| | - Hugo E Neffen
- Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
| | - Kristof Nekam
- Hungarian Allergy Association, Allergy & Immunology Department, Budapest, Hungary
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Elizabete Nunes
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Dieudonné Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Robyn O'Hehir
- Allergy, Asthma and Clinical Immunology, Alfred Health and Department of Immunology, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg; Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Ken Ohta
- Japan Antituberculosis Association (JATA), Fukujuji Hospital, Tokyo, Japan
| | - Yoshitaka Okamoto
- Chiba Rosai Hospital, ENT Department, Chiba, Japan; Chiba University Hospital, Department of Otolaryngology, Head and Neck Surgery, Chiba, Japan
| | - Kimihiro Okubo
- Deparment of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - Heidi Olze
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Mahesh Anand Padukudru
- Department of Respiratory Medicine, JSS Medical College, JSSAHER Mysuru, Karnataka, India
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain
| | - Isabella Pali-Schöll
- Institute of Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria; Interuniversity Messerli Research Institute of the University of Veterinary Medicine and Medical University Vienna, Vienna, Austria
| | - Petr Panzner
- Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Kati Palosuo
- Department of Allergology, University of Helsinki and Hospital for Skin and Allergic Diseases, Helsinki, Finland
| | - Hae S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Vincenzo Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy; Agency of Health ASL, Division of Allergy and Clinical Immunology, Department of Medicine, Salerno, Italy; Postgraduate Programme in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Benoît Pétré
- Department of Public Health, University of Liège, Liège, Belgium
| | | | - Davor Plavec
- Prima Nova, Healthcare Institution, Zagreb, Croatia; Medical Faculty, University JJ Strossmayer of Osijek, Osijek, Croatia
| | - Todor A Popov
- Clinic of Occupational Diseases, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria
| | - Francesca Puggioni
- IRCCS Humanitas Research Center, Personalized Medicine Asthma & Allergy, Rozzano, Milan, Italy
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Agné Ramonaité
- Department of Pulmonology and Allergology, Klaipeda National Hospital, Klaipeda, Lithuania; Vilnius University Medical Faculty, Department of Political Behaviour and Institutions, Vilnius, Lithuania
| | - Marysia Recto
- Division of Adult and Pediatric Allergy and Immunology, University of the Philippines - Philippines General Hospital, Manila, Philippines
| | - Susana Repka-Ramirez
- Department of Allergy, Clinics Hospital, National University, San Lorenzo, Paraguay
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom; The David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Karla Robles-Velasco
- Research Center 'Respiralab', Universidad Espíritu Santo, Samborondón, Ecuador; Department of Allergology & Pulmonology, Respiralab Research Group, Guayaquil, Guayas, Ecuador
| | - Nicolas Roche
- Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France; UMR 1016, Institut Cochin, Paris, France; Inserm, Epidemiology Department, CESP, Villejuif, France
| | | | - Joel A Romualdez
- Faculty of Medicine & Surgery, University of Santo Tomas, Manila, Philippines
| | - Menachem Rottem
- Division of Allergy, Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Philip W Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon; Department of Otorhinolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait
| | | | - Joaquin Sastre
- Allergy Service, Fundacion Jimenez Diaz, Autonoma University of Madrid, CIBERES-ISCIII, Madrid, Spain
| | - Faradiba S Serpa
- Asthma Reference Center-School of Medicine of Santa Casa de Misericórdia of Vitória, Espírito Santo, Brazil
| | - Zineb Sayah
- SMAIC Société Marocaine d'Allergologie et Immunologie Clinique, Rabat, Morocco
| | | | - Gianenrico Senna
- Asthma-Allergy Unit, University Hospital of Verona, Verona, Italy
| | - Juan Carlos Sisul
- Clínica Sisul, Allergy & Asthma, Medical Director, CLINICA SISUL, FACAAI, SPAAI, Asuncion, Paraguay
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Manuel E Soto-Martinez
- Division of Respiratory Medicine, Department of Pediatrics, Hospital Nacional de Niños, Universidad de Costa Rica, San Jose, Costa Rica
| | - Milan Sova
- Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic
| | - Olga Sozinova
- Head of Laboratory of Atmospheric processes and Aerobiology, University of Latvia, Riga, Latvia
| | - Katarina Stevanovic
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anna Szylling
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Frances M Tan
- Department of Pediatrics, Victor R Potenciano Medical Center, Mandaluyong, Philippines
| | - Pongsakorn Tantilipikorn
- Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ana Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Vesna Tomic-Spiric
- Clinic of Allergology and Immunology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladyslav Tsaryk
- Department of Clinical and Laboratory Immunology, Allergology and Medical Genetics, Bogomolets National Medical University, Kyiv, Ukraine
| | - Ioanna Tsiligianni
- International Primary Care Respiratory Group IPCRG, Aberdeen, United Kingdom; Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | | | - Marylin Valentin Rostan
- Pediatrics, Allergy & Immunology, Latín American Society of Allergy, Asthma & immunology (SLAAi), Montevideo, Uruguay
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Atmospheric Composition Research, Helsinki, Finland
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland
| | | | - Eric Van Ganse
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Pneumologie et Medicine Respiratoire, Groupement Hospitalier Nord, Hôpital de la Croix Rousse, Lyon, France
| | - Tuula Vasankari
- FiLHA, Finnish Lung Health Association, Helsinki, Finland; Department of Clinical Medicine, Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - Pakit Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, Thailand
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy
| | - Dana Wallace
- Nova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, Fla
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Susan Waserman
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Gary Wong
- Department of Paediatrics, Prince of Wales Hospital, Hong Kong, SAR, China
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Osman M Yusuf
- The Allergy and Asthma Institute, Allergy & Asthma Department, Islamabad, Pakistan
| | - Fares Zaitoun
- Clemenceau Medical Center DHCC, Lebanese-American University, Dubai, UAE
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases, Pulmonary & Allergy Department, Golnik, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Sousa‐Pinto B, Louis G, Vieira RJ, Czarlewski W, Anto JM, Amaral R, Sá‐Sousa A, Brussino L, Canonica GW, Loureiro CC, Cruz AA, Gemicioglu B, Haahtela T, Kupczyk M, Kvedariene V, Larenas‐Linnemann DE, Pham‐Thi N, Puggioni F, Regateiro FS, Romantowski J, Sastre J, Scichilone N, Taborda‐Barata L, Ventura MT, Agache I, Bedbrook A, Benfante A, Bergmann KC, Bosnic‐Anticevich S, Bonini M, Boulet L, Brusselle G, Buhl R, Cecchi L, Charpin D, Costa EM, Del Giacco S, Jutel M, Klimek L, Kuna P, Laune D, Makela M, Morais‐Almeida M, Nadif R, Niedoszytko M, Papadopoulos NG, Papi A, Pfaar O, Rivero‐Yeverino D, Roche N, Samolinski B, Shamji MH, Sheikh A, Ulrik CS, Usmani OS, Valiulis A, Yorgancioglu A, Zuberbier T, Fonseca JA, Pétré B, Louis R, Bousquet J. Relevance of individual bronchial symptoms for asthma diagnosis and control in patients with rhinitis: A MASK-air study. Clin Transl Allergy 2024; 14:e12358. [PMID: 38804596 PMCID: PMC11304469 DOI: 10.1002/clt2.12358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
RATIONALE It is unclear how each individual asthma symptom is associated with asthma diagnosis or control. OBJECTIVES To assess the performance of individual asthma symptoms in the identification of patients with asthma and their association with asthma control. METHODS In this cross-sectional study, we assessed real-world data using the MASK-air® app. We compared the frequency of occurrence of five asthma symptoms (dyspnea, wheezing, chest tightness, fatigue and night symptoms, as assessed by the Control of Allergic Rhinitis and Asthma Test [CARAT] questionnaire) in patients with probable, possible or no current asthma. We calculated the sensitivity, specificity and predictive values of each symptom, and assessed the association between each symptom and asthma control (measured using the e-DASTHMA score). Results were validated in a sample of patients with a physician-established diagnosis of asthma. MEASUREMENT AND MAIN RESULTS We included 951 patients (2153 CARAT assessments), with 468 having probable asthma, 166 possible asthma and 317 no evidence of asthma. Wheezing displayed the highest specificity (90.5%) and positive predictive value (90.8%). In patients with probable asthma, dyspnea and chest tightness were more strongly associated with asthma control than other symptoms. Dyspnea was the symptom with the highest sensitivity (76.1%) and the one consistently associated with the control of asthma as assessed by e-DASTHMA. Consistent results were observed when assessing patients with a physician-made diagnosis of asthma. CONCLUSIONS Wheezing and chest tightness were the asthma symptoms with the highest specificity for asthma diagnosis, while dyspnea displayed the highest sensitivity and strongest association with asthma control.
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Affiliation(s)
- Bernardo Sousa‐Pinto
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal
- Faculty of MedicineCINTESIS@RISE ‐ Health Research NetworkUniversity of PortoPortoPortugal
| | - Gilles Louis
- Department of Public HealthUniversity of LiègeLiègeBelgium
- GIGA I3 Research GroupUniversity of LiègeLiègeBelgium
| | - Rafael J. Vieira
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal
- Faculty of MedicineCINTESIS@RISE ‐ Health Research NetworkUniversity of PortoPortoPortugal
| | | | - Josep M. Anto
- ISGlobalBarcelona Institute for Global HealthBarcelonaSpain
- Universitat Pompeu Fabra (UPF)BarcelonaSpain
- CIBER Epidemiología y Salud Pública (CIBERESP)BarcelonaSpain
| | - Rita Amaral
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal
- Faculty of MedicineCINTESIS@RISE ‐ Health Research NetworkUniversity of PortoPortoPortugal
| | - Ana Sá‐Sousa
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal
- Faculty of MedicineCINTESIS@RISE ‐ Health Research NetworkUniversity of PortoPortoPortugal
| | - Luisa Brussino
- Department of Medical SciencesUniversity of TorinoTorinoItaly
- Allergy and Clinical Immunology UnitMauriziano HospitalTorinoItaly
| | - G. Walter Canonica
- Department of Biomedical SciencesHumanitas UniversityMilanItaly
- Asthma and Allergy UnitIRCCS Humanitas Research HospitalMilanItaly
| | - Claudia Chaves Loureiro
- Department of PneumologyFaculty of MedicineCoimbra University HospitalCoimbraPortugal
- Coimbra Institute for Clinical and Biomedical Research, CIBBCoimbraPortugal
| | - Alvaro A. Cruz
- Fundaçao ProARFederal University of Bahia and GARD/WHO Planning GroupSalvadorBahiaBrazil
| | - Bilun Gemicioglu
- Department of Pulmonary DiseasesFaculty of MedicineIstanbul University‐CerrahpaşaCerrahpaşaIstanbulTurkey
- Institute of Pulmonology and TuberculosisIstanbul University‐CerrahpaşaIstanbulTurkey
| | - Tari Haahtela
- Skin and Allergy HospitalHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and AllergyBarlicki University HospitalMedical University of LodzLodzPoland
| | - Violeta Kvedariene
- Institute of Clinical MedicineClinic of Chest Diseases and AllergologyFaculty of MedicineVilnius UniversityVilniusLithuania
- Department of PathologyInstitute of Biomedical SciencesFaculty of MedicineVilnius UniversityVilniusLithuania
| | | | - Nhân Pham‐Thi
- Ecole Polytechnique de PalaiseauPalaiseauFrance
- IRBA (Institut de Recherche Bio‐Médicale des Armées)Brétigny sur OrgeFrance
- Université Paris CitéParisFrance
| | - Francesca Puggioni
- IRCCS Humanitas Research CenterPersonalized Medicine Asthma & AllergyRozzano, MilanItaly
| | - Frederico S. Regateiro
- Allergy and Clinical Immunology UnitCentro Hospitalar e Universitário de CoimbraCoimbraPortugal
- Faculty of MedicineCenter for Innovative Biomedicine and Biotechnology (CIBB)University of CoimbraCoimbraPortugal
- Faculty of MedicineInstitute of ImmunologyUniversity of CoimbraCoimbraPortugal
- UBIAir ‐ Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
| | - Jan Romantowski
- Department of AllergologyMedical University of GdańskGdanskPoland
| | - Joaquin Sastre
- Allergy ServiceFundacion Jimenez DiazAutonoma University of MadridCIBERES‐ISCIIIMadridSpain
| | | | - Luis Taborda‐Barata
- UBIAir ‐ Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
- Department of ImmunoallergologyCova da Beira University Hospital CentreCovilhãPortugal
| | - Maria Teresa Ventura
- Allergy and Clinical ImmunologyUniversity of Bari Medical SchoolBariItaly
- Institute of Sciences of Food ProductionNational Research Council (ISPA‐CNR)BariItaly
| | - Ioana Agache
- Faculty of MedicineTransylvania University BrasovBrasovRomania
| | | | | | - Karl C. Bergmann
- Institute of AllergologyCharité—Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMPImmunology and AllergologyBerlinGermany
| | - Sinthia Bosnic‐Anticevich
- Quality Use of Respiratory Medicines GroupWoolcock Institute of Medical ResearchSydneyNew South WalesAustralia
- Macquarie Medical SchoolMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Matteo Bonini
- Department of Public Health and Infectious DiseasesSapienza University of RomeRomeItaly
- National Heart and Lung Institute (NHLI)Imperial College LondonLondonUK
| | | | - Guy Brusselle
- Department of Respiratory MedicineGhent University HospitalGhentBelgium
| | - Roland Buhl
- Department of Pulmonary MedicineMainz University HospitalMainzGermany
| | - Lorenzo Cecchi
- SOS Allergology and Clinical ImmunologyUSL Toscana CentroPratoItaly
| | - Denis Charpin
- Clinique des BronchesAllergie et SommeilHôpital NordMarseilleFrance
| | - Elisio M. Costa
- CINTESIS@RISEBiochemistry LabFaculty of Pharmacy and Competence Center on Active and Healthy AgeingUniversity of PortoPortoPortugal
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical ImmunologyUniversity Hospital “Duilio Casula”University of CagliariCagliariItaly
| | - Marek Jutel
- Department of Clinical ImmunologyWrocław Medical UniversityWroclawPoland
- ALL‐MED Medical Research InstituteWroclawPoland
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck SurgeryUniversitätsmedizin MainzMainzGermany
- Center for Rhinology and AllergologyWiesbadenGermany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and AllergyBarlicki University HospitalMedical University of LodzLodzPoland
| | | | - Mika Makela
- Skin and Allergy HospitalHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| | | | - Rachel Nadif
- Université Paris‐SaclayUVSQUniversity Paris‐SudVillejuifFrance
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
| | - Marek Niedoszytko
- UBIAir ‐ Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
- Department of AllergologyMedical University of GdańskGdanskPoland
| | | | - Alberto Papi
- Respiratory MedicineDepartment of Translational MedicineUniversity of FerraraFerraraItaly
| | - Oliver Pfaar
- Section of Rhinology and AllergyDepartment of OtorhinolaryngologyHead and Neck SurgeryUniversity Hospital MarburgPhilipps‐Universität MarburgMarburgGermany
| | | | - Nicolas Roche
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
- PneumologieAP‐HP Centre Université de Paris CitéHôpital CochinParisFrance
- UMR 1016Institut CochinParisFrance
| | - Boleslaw Samolinski
- Department of Prevention of Environmental HazardsAllergology and ImmunologyMedical University of WarsawWarsawPoland
| | - Mohamed H. Shamji
- National Heart and Lung Institute (NHLI)Imperial College LondonLondonUK
- NIHR Imperial Biomedical Research CentreLondonUK
| | - Aziz Sheikh
- Usher InstituteThe University of EdinburghEdinburghUK
| | - Charlotte Suppli Ulrik
- Department of Respiratory MedicineCopenhagen University Hospital‐HvidovreCopenhagenDenmark
- Institute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Omar S. Usmani
- National Heart and Lung Institute (NHLI)Imperial College LondonLondonUK
- Institute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Airways Disease SectionRoyal Brompton HospitalLondonUK
| | - Arunas Valiulis
- Interdisciplinary Research Group of Human EcologyInstitute of Clinical Medicine and Institute of Health SciencesMedical Faculty of Vilnius UniversityVilniusLithuania
- European Academy of Paediatrics (EAP/UEMS‐SP)BrusselBelgium
| | - Arzu Yorgancioglu
- Department of Pulmonary DiseasesFaculty of MedicineCelal Bayar UniversityManisaTurkey
| | - Torsten Zuberbier
- Institute of AllergologyCharité—Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMPImmunology and AllergologyBerlinGermany
| | - Joao A. Fonseca
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal
- Faculty of MedicineCINTESIS@RISE ‐ Health Research NetworkUniversity of PortoPortoPortugal
| | - Benoit Pétré
- Department of Public HealthUniversity of LiègeLiègeBelgium
| | - Renaud Louis
- GIGA I3 Research GroupUniversity of LiègeLiègeBelgium
- Department of Pulmonary MedicineCHU LiègeLiègeBelgium
| | - Jean Bousquet
- MASK‐airMontpellierFrance
- ARIAMontpellierFrance
- Institute of AllergologyCharité—Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMPImmunology and AllergologyBerlinGermany
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
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Vieira RJ, Sousa‐Pinto B, Bognanni A, Yepes‐Nuñez JJ, Zhang Y, Lityńska J, Sadowska E, Borowiack E, Samolinski B, Togias A, Zuberbier T, Bousquet J, Schünemann HJ. Embedding patients' values and preferences in guideline development for allergic diseases: The case study of Allergic Rhinitis and its Impact on Asthma 2024. Clin Transl Allergy 2024; 14:e12377. [PMID: 38862272 PMCID: PMC11166500 DOI: 10.1002/clt2.12377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 06/01/2024] [Indexed: 06/13/2024] Open
Abstract
Recommendations for or against the use of interventions need to consider both desirable and undesirable effects as well as patients' values and preferences (V&P). In the decision-making context, patients' V&P represent the relative importance people place on the outcomes resulting from a decision. Therefore, the balance between desirable and undesirable effects from an intervention should depend not only on the difference between benefits and harms but also on the value that patients place on them. V&P are therefore one of the criteria to be considered when formulating guideline recommendations in the Evidence-to-Decision framework developed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Working Group. Patients' V&P may be quantified through utilities, which can be elicited using direct methods (e.g., standard gamble or time trade-off) or indirect methods (using validated instruments to measure health-related quality of life, such as EQ-5D). The GRADE approach recommends conducting systematic reviews to summarise all the available evidence and assess the degree of certainty on V&P. In this article, we discuss the importance of considering patients' V&P and provide examples of how they are considered in the 2024 person-centred Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines.
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Affiliation(s)
- Rafael José Vieira
- Department of Community MedicineInformation and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
- Centre for Health Technology and Services ResearchHealth Research Network (CINTESIS@RISE)Faculty of MedicineUniversity of PortoPortoPortugal
| | - Bernardo Sousa‐Pinto
- Department of Community MedicineInformation and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
- Centre for Health Technology and Services ResearchHealth Research Network (CINTESIS@RISE)Faculty of MedicineUniversity of PortoPortoPortugal
| | - Antonio Bognanni
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
- Department of MedicineEvidence in Allergy GroupMcMaster UniversityHamiltonOntarioCanada
| | - Juan José Yepes‐Nuñez
- School of MedicineUniversidad de los AndesBogotáColombia
- Pulmonology ServiceInternal Medicine SectionFundación Santa Fe de BogotáUniversity HospitalBogotáColombia
| | - Yuan Zhang
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
| | | | | | | | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarsawPoland
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation (DAIT)National Institute of Allergy and Infectious DiseasesNIHBethesdaMarylandUSA
| | - Torsten Zuberbier
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and AllergologyBerlinGermany
- Fraunhofer Cluster of Excellence for Immune‐Mediated Diseases CIMDFrankfurtGermany
| | - Jean Bousquet
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and AllergologyBerlinGermany
- Fraunhofer Cluster of Excellence for Immune‐Mediated Diseases CIMDFrankfurtGermany
| | - Holger J. Schünemann
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
- Michael G. DeGroote Cochrane Canada & McMaster GRADE CentresMcMaster UniversityHamiltonOntarioCanada
- Department of MedicineMcMaster UniversityHamiltonOntarioCanada
- Department of Biomedical SciencesHumanitas UniversityMilanItaly
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8
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Vieira RJ, Leemann L, Briggs A, Pereira AM, Savouré M, Kuna P, Morais-Almeida M, Bewick M, Azevedo LF, Louis R, Klimek L, Bahbah F, Samolinski B, Anto JM, Zuberbier T, Fonseca JA, Bousquet J, Sousa-Pinto B. Poor Rhinitis and Asthma Control Is Associated With Decreased Health-Related Quality of Life and Utilities: A MASK-air Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1530-1538.e6. [PMID: 38561141 DOI: 10.1016/j.jaip.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Allergic rhinitis (AR) and asthma may affect health-related quality of life. However, national estimates on the quality of life of patients with AR or asthma are lacking. OBJECTIVE To provide estimates for utility scores and EuroQoL five-dimension (EQ-5D) visual analog scale (VAS) for patients with AR or asthma. METHODS We conducted a cross-sectional study using direct patient data from the MASK-air app on European MASK-air users with self-reported AR or asthma. We used a multi-attribute instrument (EQ-5D) to measure quality of life (as utility scores and EQ-5D VAS values). Mean scores were calculated per country and disease control level using multilevel regression models with poststratification, accounting for age and sex biases. RESULTS We assessed data from 7905 MASK-air users reporting a total of up to 82,737 days. For AR, utilities ranged from 0.86 to 0.99 for good control versus 0.72 to 0.85 for poor control; EQ-5D VAS levels ranged from 78.9 to 87.9 for good control versus 55.3 to 64.2 for poor control. For asthma, utilities ranged from 0.84 to 0.97 for good control versus 0.73 to 0.87 for poor control; EQ-5D VAS levels ranged from 68.4 to 81.5 for good control versus 51.4 to 64.2 for poor control. Poor disease control was associated with a mean loss of 0.14 utilities for both AR and asthma. For the same control levels, AR and asthma were associated with similar utilities and EQ-5D VAS levels. However, lower values were observed for asthma plus AR compared with AR alone. CONCLUSIONS Poor AR or asthma control are associated with reduced quality of life. The estimates obtained from mobile health data may provide valuable insights for health technology assessment studies.
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Affiliation(s)
- Rafael José Vieira
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Lucas Leemann
- Department of Political Science, University of Zurich, Zurich, Switzerland
| | - Andrew Briggs
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ana Margarida Pereira
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Marine Savouré
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France; Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Sud, Villejuif, France
| | - Piotr Kuna
- Division of Internal Medicine, Asthma, and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | | | - Michael Bewick
- University of Central Lancashire Medical School, Preston, United Kingdom
| | - Luís Filipe Azevedo
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Liège, Liège, Belgium; GIGA I3 Research Group, University of Liège, Liège, Belgium
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany
| | | | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany
| | - João A Fonseca
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany; MASK-air SAS, Montpellier, France.
| | - Bernardo Sousa-Pinto
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
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9
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Abreu MIT, Santos AF, Gama JMR, Valente S, Valente MJ, Pereira H, Regateiro F, Sousa-Pinto B, Ventura MT, Bousquet J, Taborda-Barata L. Factors Affecting Usage of a Digital Asthma Monitoring Application by Old-Age Asthmatics Living in Inner Central Portugal. Clin Interv Aging 2024; 19:971-979. [PMID: 38827238 PMCID: PMC11143487 DOI: 10.2147/cia.s448797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/01/2024] [Indexed: 06/04/2024] Open
Abstract
Purpose To analyse factors affecting the ability to use the digital asthma monitoring application Mask-Air® in old-age individuals living in inland Portugal. Patients and Methods In this observational study, patients with medically confirmed asthma who agreed to participate were interviewed and subdivided into Non-users Group: those who could not use the application and Users Group: those who could. Sociodemographic and psychological data, comorbidities, and asthma status were compared between groups. Assessment of reasons for refusal was based on a 6-item questionnaire. Results Among the 72 sequentially recruited patients (mean age±SD 73.26±5.43 yrs; 61 women; 11 men), 44 (61.1%; mean age±SD 74.64±5.68 yrs; 38 women; 6 men)) were included in Non-users Group and 28 (38.9%; mean age±SD 71.11±4.26 yrs; 23 women; 5 men) in Users Group. Non-users Group patients were significantly older, had lower socioeconomic level, and more frequently had severe asthma (25% vs 3.6%; Odds ratio=0.08 (95% CI=0.01-0.81; p=0.033)) and diabetes (32.6% vs 7.4%; Odds ratio=0.17 (95% CI=0.03-0.80; p=0.025)) than Users Group. The main reasons for not using the App were "Lack of required hardware" (n=35) and "Digital illiteracy" (n=26), but lack of interest to use the App among those who had conditions to use it was uncommon. Conclusion Most old-age asthmatics living in Beira Interior either lack a smartphone or digital skills, which are significant obstacles to implementing app-based monitoring studies.
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Affiliation(s)
| | - Adalberto Fernandes Santos
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- Faculty of Medicine, Agostinho Neto University, Luanda, Angola
| | - Jorge M R Gama
- Center of Mathematics and Applications, Faculty of Sciences, University of Beira Interior, Covilhã, Portugal
| | - Salete Valente
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Department of Pulmonology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Maria Jesus Valente
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Department of Pulmonology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Henrique Pereira
- Psychology and Education Department, Faculty of Human and Social Sciences, University of Beira Interior, Covilhã, Portugal
- The Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Beira Interior, Covilhã, Portugal
| | - Frederico Regateiro
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- Institute of Immunology, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
- Centro de Neurociências e Biologia Celular, CIBB, University of Coimbra, Coimbra, Portugal
- Allergy & Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
- Institute of Science of Food Production, National Research Council (Ispa-Cnr), Bari, Italy
| | - Jean Bousquet
- Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
- Department of Pulmonology, University Hospital Montpellier, Montpellier, France
| | - Luis Taborda-Barata
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- UBIAir - Clinical & Experimental Lung Centre, UBIMedical, University of Beira Interior, Covilhã, Portugal
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
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10
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Bousquet J, Gherasim A, de Blay F, Mathieu‐Dupas E, Batot G, Laune D, Sousa‐Pinto B, Zuberbier T, Pham‐Thi N. Proof-of-concept study of anti-Fel d 1 IgY antibodies in cat food using the MASK-air ® app. Clin Transl Allergy 2024; 14:e12353. [PMID: 38676659 PMCID: PMC11055507 DOI: 10.1002/clt2.12353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/29/2024] [Accepted: 03/31/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND An innovation to better manage cat-allergic patients utilises anti-Fel d 1 IgY antibodies to neutralise Fel d 1 after its production by the cat. However, there is no published study showing its clinical efficacy in humans in a home setting. A longitudinal, open-label, proof-of-concept study was carried out to approach clinical efficacy of the cat food in cat-allergic patients. METHODS After a baseline evaluation, the cats ate only the cat food for the following 4 months. Daily evaluation of efficacy was performed for 2 weeks at baseline and after 1, 2 and 3 months of intervention for periods of 2 weeks. The MASK-air app was used daily to assess symptoms, work productivity and medications. RESULTS Of the 49 patients screened, 42 were followed up and 33 (78.5%) reported MASK-air data at all 3 evaluation periods. The primary end point (visual analogue scale [VAS] for global allergy symptoms) was significantly improved (p < 0.0001). All symptoms (VAS nose, eye, and asthma), VAS work and the combined symptom-medication score significantly improved after 1 month. The percentage of uncontrolled days (VAS>20/100) decreased from 64% at baseline to 35% at 1 month (p < 0.0001) and 14% at 3 months. A sensitivity analysis in patients with uncontrolled disease at baseline found similar results. DISCUSSION A cat diet containing anti-Fel d 1 antibodies was able to (i) show decreased allergic symptoms and related outcomes, (ii) inform the design and feasibility of future studies with a control arm and (iii) estimate the sample size of the study. STUDY REGISTRATION NUMBER clinicaltrials.gov: NCT05656482.
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Affiliation(s)
- Jean Bousquet
- Institute of AllergologyCharité—Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and AllergologyBerlinGermany
- MASK‐airMontpellierFrance
| | - Alina Gherasim
- ALYATECNouvel hôpital Civil‐Hôpitaux UniversitairesStransbourgFrance
| | - Frédéric de Blay
- Allergy Division, Chest Disease DepartmentUniversity Hospital of StrasbourgStrasbourgFrance
- Federation of Translational MedicineUniversity of StrasbourgStrasbourgFrance
| | | | | | | | - Bernardo Sousa‐Pinto
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of PortoPortoPortugal
- CINTESIS@RISE ‐ Health Research Network, Faculty of Medicine, University of PortoPortoPortugal
| | - Torsten Zuberbier
- Institute of AllergologyCharité—Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and AllergologyBerlinGermany
| | - Nhân Pham‐Thi
- Ecole Polytechnique de PalaiseauPalaiseauFrance
- IRBA (Institut de Recherche Bio‐Médicale des Armées)Brétigny sur OrgeFrance
- Université Paris CitéParisFrance
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11
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Wong LSY, Akenroye A, Eigenmann P, Tham EH. Editorial comments on "Asthma and rhinitis control in adolescents and young adults: A real-world MASK-air study". Pediatr Allergy Immunol 2024; 35:e14134. [PMID: 38702900 DOI: 10.1111/pai.14134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 05/06/2024]
Affiliation(s)
- Lydia Su Yin Wong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore, Singapore
| | - Ayobami Akenroye
- Division of Allergy and Clinical Immunology, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Philippe Eigenmann
- Pediatric Allergy Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Elizabeth Huiwen Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore, Singapore
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12
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Aggelidis X, Kritikou M, Makris M, Miligkos M, Papapostolou N, Papadopoulos NG, Xepapadaki P. Tele-Monitoring Applications in Respiratory Allergy. J Clin Med 2024; 13:898. [PMID: 38337592 PMCID: PMC10856055 DOI: 10.3390/jcm13030898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Respiratory allergic diseases affect over 500 million people globally and pose a substantial burden in terms of morbidity, mortality, and healthcare costs. Restrictive factors such as geographical disparities, infectious pandemics, limitations in resources, and shortages of allergy specialists in underserved areas impede effective management. Telemedicine encompasses real-time visits, store-and-forward option triage, and computer-based technologies for establishing efficient doctor-patient communication. Recent advances in digital technology, including designated applications, informative materials, digital examination devices, wearables, digital inhalers, and integrated platforms, facilitate personalized and evidence-based care delivery. The integration of telemonitoring in respiratory allergy care has shown beneficial effects on disease control, adherence, and quality of life. While the COVID-19 pandemic accelerated the adoption of telemedicine, certain concerns regarding technical requirements, platform quality, safety, reimbursement, and regulatory considerations remain unresolved. The integration of artificial intelligence (AI) in telemonitoring applications holds promise for data analysis, pattern recognition, and personalized treatment plans. Striking the balance between AI-enabled insights and human expertise is crucial for optimizing the benefits of telemonitoring. While telemonitoring exhibits potential for enhancing patient care and healthcare delivery, critical considerations have to be addressed in order to ensure the successful integration of telemonitoring into the healthcare landscape.
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Affiliation(s)
- Xenofon Aggelidis
- Allergy Unit, 2nd Department of Dermatology and Venereology, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (X.A.); (M.M.); (N.P.)
| | - Maria Kritikou
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece; (M.M.); (N.G.P.); (P.X.)
| | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (X.A.); (M.M.); (N.P.)
| | - Michael Miligkos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece; (M.M.); (N.G.P.); (P.X.)
| | - Niki Papapostolou
- Allergy Unit, 2nd Department of Dermatology and Venereology, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (X.A.); (M.M.); (N.P.)
| | - Nikolaos G. Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece; (M.M.); (N.G.P.); (P.X.)
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece; (M.M.); (N.G.P.); (P.X.)
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13
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Sousa-Pinto B, Valiulis A, Melén E, Koppelman GH, Papadopoulos NG, Makela M, Haahtela T, Bonini M, Braido F, Brussino L, Cruz AA, Fiocchi A, Giovannini M, Gemicioglu B, Kulus M, Kuna P, Kupczyk M, Kvedariene V, Larenas-Linnemann DE, Louis R, Morais-Almeida M, Niedoszytko M, Ollert M, Pfaar O, Regateiro FS, Roberts G, Samolinski B, Savouré M, Taborda-Barata L, Toppila-Salmi S, Ventura MT, Vazquez-Ortiz M, Vieira RJ, Fonseca JA, Yorgancioglu A, Zuberbier T, Anto JM, Bousquet J, Pham-Thi N. Asthma and rhinitis control in adolescents and young adults: A real-world MASK-air study. Pediatr Allergy Immunol 2024; 35:e14080. [PMID: 38334246 DOI: 10.1111/pai.14080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND In allergic rhinitis and asthma, adolescents and young adult patients are likely to differ from older patients. We compared adolescents, young adults and adults on symptoms, control levels, and medication adherence. METHODS In a cross-sectional study (2015-2022), we assessed European users of the MASK-air mHealth app of three age groups: adolescents (13-18 years), young adults (18-26 years), and adults (>26 years). We compared them on their reported rhinitis and asthma symptoms, use and adherence to rhinitis and asthma treatment and app adherence. Allergy symptoms and control were assessed by means of visual analogue scales (VASs) on rhinitis or asthma, the combined symptom-medication score (CSMS), and the electronic daily control score for asthma (e-DASTHMA). We built multivariable regression models to compare symptoms or medication accounting for potential differences in demographic characteristics and baseline severity. RESULTS We assessed 965 adolescent users (15,252 days), 4595 young adults (58,161 days), and 15,154 adult users (258,796 days). Users of all three age groups displayed similar app adherence. In multivariable models, age groups were not found to significantly differ in their adherence to rhinitis or asthma medication. These models also found that adolescents reported lower VAS on global allergy, ocular, and asthma symptoms (as well as lower CSMS) than young adults and adults. CONCLUSIONS Adolescents reported a better rhinitis and asthma control than young adults and adults, even though similar medication adherence levels were observed across age groups. These results pave the way for future studies on understanding how adolescents control their allergic diseases.
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Affiliation(s)
- Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Arunas Valiulis
- Interdisciplinary Research Group of Human Ecology, Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania
- European Academy of Paediatrics, (EAP/UEMS-SP), Brussels, Belgium
| | - Erik Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Gerard H Koppelman
- Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, GRIACResearch Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Mika Makela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Matteo Bonini
- Department of Cardiovascular and Respiratory Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy
- Department of Neurological, ENT and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, Italy
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Fulvio Braido
- Respiratory Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luisa Brussino
- Department of Medical Sciences, University of Torino, Torino, Italy
- Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy
| | - Alvaro A Cruz
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - Alessandro Fiocchi
- Allergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Marek Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Violeta Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Désirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Liège, Liège, Belgium
- GIGA I3 Research Group, University of Liège, Liège, Belgium
| | | | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK
- The David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Marine Savouré
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - Luis Taborda-Barata
- UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Sanna Toppila-Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Kupio, Finland
- Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Maria Teresa Ventura
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy
- Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
| | - Marta Vazquez-Ortiz
- Section of Inflammation, Repair and Development, Imperial College London, National Heart and Lung Institute, London, UK
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
| | - Rafael José Vieira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joao A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- MASK-air, Montpellier, France
| | - Nhân Pham-Thi
- Ecole Polytechnique de Palaiseau, Palaiseau, France
- IRBA (Institut de Recherche Bio-Médicale des Armées), Brétigny sur Orge, France
- Université Paris Cité, Paris, France
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14
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Neisinger S, Sousa Pinto B, Ramanauskaite A, Bousquet J, Weller K, Metz M, Magerl M, Kocatürk E, Cherrez‐Ojeda I, Gimenez‐Arnau AM, Parisi CAS, Altrichter S, Ensina LF, Bouillet L, Asero R, Gonçalo M, Guillet C, Rutkowski K, Bernstein JA, Hardin H, Godse K, Brzoza Z, Sousa JIL, Thomsen SF, van Doorn M, Hide M, Ye Y, Vanderse S, Lapiņa L, Peter J, Zhao Z, Han L, Nasr I, Rockmann‐Helmbach H, Sørensen JA, Kara RÖ, Kurjāne N, Kurchenko AI, Kaidashev I, Tsaryk V, Stepanenko R, Maurer M. CRUSE ® -An innovative mobile application for patient monitoring and management in chronic spontaneous urticaria. Clin Transl Allergy 2024; 14:e12328. [PMID: 38282190 PMCID: PMC10764293 DOI: 10.1002/clt2.12328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE® , the Chronic Urticaria Self Evaluation app, aims to address this unmet need. METHODS CRUSE® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real-time insights. Additionally, CRUSE® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations. RESULTS CRUSE® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country-specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second-generation antihistamines were used in 74.0% of days. CONCLUSIONS The initial data from CRUSE® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.
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15
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Bousquet J, Sousa-Pinto B, Regateiro FS, Pereira AM, Brussino L, Kvedariene V, Larenas-Linnemann DE, Taborda-Barata L, Ventura MT, Vieira RJ, Fonseca JA, Zuberbier T, Anto JM. MASK-air® direct patient data support the ARIA-MeDALL hypothesis on allergic phenotypes. Allergy 2023; 78:2790-2794. [PMID: 37564010 DOI: 10.1111/all.15842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/10/2023] [Accepted: 07/28/2023] [Indexed: 08/12/2023]
Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- MASK-air, Montpellier, France
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Margarida Pereira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luisa Brussino
- Department of Medical Sciences, University of Torino, Torino, Italy
- Allergy and Clinical Immunology Unit, Mauriziano Hospital, Torino, Italy
| | - Violeta Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Department of Pathology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Désirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Luis Taborda-Barata
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
- UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Maria Teresa Ventura
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy
- Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
| | - Rafael José Vieira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joao A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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16
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Bousquet J, Samolinski B, Kaidashev I, Maurer M, Roche N, Sousa-Pinto B, Kurchenko A, Stepanenko R, Tsaryk V, Klimek L, Ventura MT, Bedbrook A, Czarlewski W, Lysanets Y, Kupczyk M, Skolimowski Ł, Kulus M, Del Giacco S, Ollert M, Garcia-Aymerich J, Robalo Cordeiro C, Yorgancioglu A, Schlapbach C, Amaral R, Bonaglia C, Bossé I, Buquicchio R, Christou D, Fedoruk G, Fontanesi P, Gemicioglu B, Giuliano AFM, Lepore P, Nakonechna A, Neisinger S, Pereira AM, Ramanauskaite A, Raciborski F, Sitkauskiene B, Sokhatska O, Stepanenko V, Stevanovic K, Syzon O, Kvedariene V, de Vries G, van Eerd M, Valiulis A, Fonseca JA, Anto JM, Haahtela T, Schünemann H, Zuberbier T. UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) action plan. Allergy 2023; 78:2581-2595. [PMID: 37641384 DOI: 10.1111/all.15855] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/26/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023]
Abstract
Eight million Ukrainians have taken refuge in the European Union. Many have asthma and/or allergic rhinitis and/or urticaria, and around 100,000 may have a severe disease. Cultural and language barriers are a major obstacle to appropriate management. Two widely available mHealth apps, MASK-air® (Mobile Airways Sentinel NetworK) for the management of rhinitis and asthma and CRUSE® (Chronic Urticaria Self Evaluation) for patients with chronic spontaneous urticaria, were updated to include Ukrainian versions that make the documented information available to treating physicians in their own language. The Ukrainian patients fill in the questionnaires and daily symptom-medication scores for asthma, rhinitis (MASK-air) or urticaria (CRUSE) in Ukrainian. Then, following the GDPR, patients grant their physician access to the app by scanning a QR code displayed on the physician's computer enabling the physician to read the app contents in his/her own language. This service is available freely. It takes less than a minute to show patient data to the physician in the physician's web browser. UCRAID-developed by ARIA (Allergic Rhinitis and its Impact on Asthma) and UCARE (Urticaria Centers of Reference and Excellence)-is under the auspices of the Ukraine Ministry of Health as well as European (European Academy of Allergy and Clinical immunology, EAACI, European Respiratory Society, ERS, European Society of Dermatologic Research, ESDR) and national societies.
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Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- MASK-air, Montpellier, France
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | | | - Marcus Maurer
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Nicolas Roche
- Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France
- UMR 1016, Institut Cochin, Paris, France
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andrii Kurchenko
- Department of Clinical Immunology and Allergology with section of Medical Genetic, Bogomolets National Medical University, Kiev, Ukraine
| | - Roman Stepanenko
- Department of Dermatology and Venereology with Cosmetology Course, Bogomolets National Medical University, Kiev, Ukraine
| | - Vladyslav Tsaryk
- Department of Clinical Immunology and Allergology with section of Medical Genetic, Bogomolets National Medical University, Kiev, Ukraine
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Maria Teresa Ventura
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy
- Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
| | - Anna Bedbrook
- MASK-air, Montpellier, France
- ARIA, Montpellier, France
| | | | | | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | | | - Marek Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital 'Duilio Casula', University of Cagliari, Cagliari, Italy
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
- Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Carlos Robalo Cordeiro
- Department of Pneumology, Coimbra University Hospital, Faculty of Medicine, Coimbra, Portugal
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | | | - Rita Amaral
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Cristina Bonaglia
- Institute 'Bona Sforza', University for Linguistic Mediators, Bari, Italy
| | | | | | - Demetrios Christou
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Galyna Fedoruk
- Department of Clinical Immunology and Allergology with section of Medical Genetic, Bogomolets National Medical University, Kiev, Ukraine
| | - Pietro Fontanesi
- Institute 'Bona Sforza', University for Linguistic Mediators, Bari, Italy
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Antonio F M Giuliano
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy
- Department of Internal Medicine 'A. Murri', University of Bari Medical School, Bari, Italy
| | - Paolo Lepore
- Rotary Club Bari Mediterranean RY23/24, Bari, Italy
| | - Alla Nakonechna
- Clinical Immunology and Allergy Unit, Sheffield Teaching Hospitals, Sheffield, UK
- University of Liverpool, Liverpool, UK
| | - Sophia Neisinger
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Ana M Pereira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Aiste Ramanauskaite
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Brigita Sitkauskiene
- Department of Immunology and Allergology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Oksana Sokhatska
- Basic & Clinical Immunology Unit, Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Viktor Stepanenko
- Department of Dermatology and Venereology with Cosmetology Course, Bogomolets National Medical University, Kiev, Ukraine
| | - Katarina Stevanovic
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Orysya Syzon
- Department of Dermatology, Venereology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Violeta Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Department of Pathology, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
| | | | | | - Arunas Valiulis
- Interdisciplinary Research Group of Human Ecology, Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania
- European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - Joao A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Holger Schünemann
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
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17
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Buekers J, Stas M, Aerts R, Bruffaerts N, Dujardin S, Van Nieuwenhuyse A, Van Orshoven J, Chevance G, Somers B, Aerts JM, Garcia-Aymerich J. Daily allergy burden and heart rate characteristics in adults with allergic rhinitis based on a wearable telemonitoring system. Clin Transl Allergy 2023; 13:e12242. [PMID: 37186425 PMCID: PMC10126716 DOI: 10.1002/clt2.12242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/07/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Allergic rhinitis includes a certain degree of autonomic imbalance. However, no information is available on how daily changes in allergy burden affect autonomic imbalance. We aimed to estimate associations between daily allergy burden (allergy symptoms and mood) and daily heart rate characteristics (resting heart rate and sample entropy, both biomarkers of autonomic balance) of adults with allergic rhinitis, based on real-world measurements with a wearable telemonitoring system. METHODS Adults with a tree pollen allergy used a smartphone application to self-report daily allergy symptoms (score 0-44) and mood (score 0-4), and a Mio Alpha 2 wristwatch to collect heart rate characteristics during two pollen seasons of hazel, alder and birch in Belgium. Associations between daily allergy burden and heart rate characteristics were estimated using linear mixed effects distributed lag models with a random intercept for individuals and adjusted for potential confounders. RESULTS Analyses included 2497 participant-days of 72 participants. A one-point increase in allergy symptom score was associated with an increase in next-day resting heart rate of 0.08 (95% CI: 0.02-0.15) beats per minute. A one-point increase in mood score was associated with an increase in same-day sample entropy of 0.80 (95% CI: 0.34-1.26) × 10-2 . No associations were found between allergy symptoms and heart rate sample entropy, nor between mood and resting heart rate. CONCLUSION Daily repeated measurements with a wearable telemonitoring system revealed that the daily allergy burden of adults with allergic rhinitis has systemic effects beyond merely the respiratory system.
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Affiliation(s)
- Joren Buekers
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Measure, Model & Manage Bioresponses (M3-BIORES), Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Michiel Stas
- Measure, Model & Manage Bioresponses (M3-BIORES), Department of Biosystems, KU Leuven, Leuven, Belgium
- Division of Forest, Nature and Landscape, Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
| | - Raf Aerts
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Division of Ecology, Evolution and Biodiversity Conservation, KU Leuven, Leuven, Belgium
- Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
| | - Nicolas Bruffaerts
- Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Brussels, Belgium
| | - Sebastien Dujardin
- Department of Geography, University of Namur, Namur, Belgium
- Institute for Life, Earth and Environment (ILEE), University of Namur, Namur, Belgium
| | - An Van Nieuwenhuyse
- Centre of Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg
| | - Jos Van Orshoven
- Division of Forest, Nature and Landscape, Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
| | - Guillaume Chevance
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ben Somers
- Division of Forest, Nature and Landscape, Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
- KU Leuven Urban Studies Institute, KU Leuven, Leuven, Belgium
| | - Jean-Marie Aerts
- Measure, Model & Manage Bioresponses (M3-BIORES), Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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